CMS Price Transparency Data

X-ray, pelvis

Facility: Ira Davenport Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $230
  • Cash Discount Price: $207
  • vs. Medicare Baseline: 2.15x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Ira Davenport Memorial Hospital is $230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $207. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.15x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.
Cash / Self-Pay
$207

Average discount available for prompt cash payment at this facility.

Insurance Median
$230

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: $207 (194%)
Insurance Median: $230 (215%)
Cash: $207 (194% of Medicare)
Ins. Median: $230 (215% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 215% of the Medicare baseline (a markup of 115%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Empire $6 - $25 6%
Blue Cross Blue Shield $34 - $1,073 32%
Fidelis $112 105%
Humana $126 - $318 118%
Tricare $126 118%
Amerihealth Caritas Mcr Adv - All Plans $127 119%
Fidelis Care - Exchange - All Plans $187 - $194 175%
Geisinger - All Plans $198 - $206 185%
Cigna $212 - $220 198%
Mvp Health Plan - All Plans $212 - $220 198%
Independent Health - All Plans $221 - $230 207%
Upmc - All Plans $235 - $244 220%
Pomco Inc - All Plans $245 - $255 229%
Aetna $255 - $316 239%
UnitedHealthcare $255 - $371 239%
Emblem Health - All Plans $299 - $311 280%
Emblem/Ghi $314 - $327 294%
Martins Point - All Plans $340 - $354 318%
Healthnow - All Plans $1,120 - $1,165 1049%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7571 State Route 54, Bath, NY 14810
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Rural Emergency Hospital