CMS Price Transparency Data

X-ray, pelvis

Facility: Bertrand Chaffee Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $21
  • Cash Discount Price: $75
  • vs. Medicare Baseline: 0.20x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Bertrand Chaffee Hospital is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.20x the Medicare baseline. Located in 224 East Main Street, Springville, NY.
Cash / Self-Pay
$75

Average discount available for prompt cash payment at this facility.

Insurance Median
$21

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: $75 (70%)
Insurance Median: $21 (20%)
Cash: $75 (70% of Medicare)
Ins. Median: $21 (20% 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
Comm Blue Essential $8 7%
Community Blue $8 7%
Community Care - Bc $8 7%
Fidelis Care Of New York $8 7%
Ghi Medical $8 7%
Gowanda Correctional Fac $8 7%
Medicaid / KanCare $8 7%
Molina Essential Plan $8 7%
Molina Heathcare Of Wny $8 7%
Seneca Nation Health Dept $8 7%
United Hc - Community Pln $8 7%
United Hc Essential Plan $8 7%
Univera Hc Myhealth $8 7%
Univera Hc Myhealth+ $8 - $23 7%
Yourcare $8 7%
Private Pay $17 - $134 16%
Aetna $20 - $157 19%
American Progressive Ins. $20 - $157 19%
Blue Cross Blue Shield $20 - $22 19%
Cigna $20 - $157 19%
Commercial / Misc $20 - $157 19%
Global Excel Mgt $20 - $157 19%
Guardian Life Ins. Co. $20 - $157 19%
Mvp Commercial $20 - $157 19%
No Amer Meritian Health $20 - $157 19%
No-Fault $20 - $157 19%
Senior Blue - Bc $20 19%
Univera Essential Plans $23 22%
Univera Hc Child Health+ $23 22%
Univera Plus Med $23 22%
Univera Senior Choice $27 25%
Fidelis Essential Plans $28 26%
Univera Healthcare $33 31%
Iha Essential Plans $82 - $91 77%
Iha Medisource $82 - $91 77%
Iha Encompass 65 $127 119%
Iha $131 123%
Iha Custom Coverage $131 123%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 224 East Main Street, Springville, NY 14141
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals