CMS Price Transparency Data

X-ray, pelvis

Facility: Glens Falls Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $29
Cash Discount Price: $81
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Glens Falls Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.27x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$29

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: $81 (76%)

Insurance Median: $29 (27%)

Cash: $81 (76% of Medicare)

Ins. Median: $29 (27% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$9 - $263	8%
Cdphp	$18 - $135	17%
Medicaid / KanCare	$18 - $25	17%
Medicare (plans)	$19 - $26	18%
UnitedHealthcare	$19 - $224	18%
Blue Cross Blue Shield	$20 - $171	19%
Emblem Health Ghi	$22 - $26	21%
Blue Shield	$25 - $87	23%
Mvp	$25 - $126	23%
Tricare	$25 - $26	23%
Fidelis	$26 - $158	24%
Mvp Commercial	$26 - $94	24%
Blue Shield Highmark	$32 - $78	30%
Cigna	$39 - $47	37%
Hamaspik	$171	160%
Nascentia Health Options	$171	160%
Magnacare	$197	184%
Emblem	$210	197%
Empire Plan Nyship	$224	210%
Multiplan	$224	210%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $81.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72170.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Glens Falls Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72170.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.