CMS Price Transparency Data

X-ray, pelvis

Facility: Jones Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $23
  • Cash Discount Price: $202
  • vs. Medicare Baseline: 0.22x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Jones Memorial Hospital is $23. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.22x the Medicare baseline. Located in 191 North Main Street, Wellsville, NY.
Cash / Self-Pay
$202

Average discount available for prompt cash payment at this facility.

Insurance Median
$23

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $202 (189%)
Insurance Median: $23 (22%)
Cash: $202 (189% of Medicare)
Ins. Median: $23 (22% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $6 - $28 6%
UnitedHealthcare $7 - $140 7%
Independent Health 5156 $8 - $203 7%
Medicare (plans) $8 - $203 7%
Univera Healthcare 1706 $8 - $13 7%
Fidelis 5155 $8 - $38 7%
Excellus 2201 $8 - $33 7%
Blue Cross Blue Shield $8 - $273 7%
Aetna $8 - $148 7%
Cigna $11 - $342 10%
Molina Healthcare 1723 $14 - $28 13%
Capital District Physicians Health Plan (Cdphp) 5149 $21 - $69 20%
Mvp 2900 $33 - $330 31%
UPMC Health Plan 5138 $105 98%
Humana $140 131%
Total Senior Care 1319 $140 131%
Empire Plan 5179 $247 231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 191 North Main Street, Wellsville, NY 14895
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals