CMS Price Transparency Data

X-ray, pelvis

Facility: University Hospitals Samaritan Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $199
  • Cash Discount Price: $178
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at University Hospitals Samaritan Medical Center is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.86x the Medicare baseline. Located in 1025 Center St, Ashland, OH.
Cash / Self-Pay
$178

Average discount available for prompt cash payment at this facility.

Insurance Median
$199

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: $178 (167%)
Insurance Median: $199 (186%)
Cash: $178 (167% of Medicare)
Ins. Median: $199 (186% 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
Medical Mutual Of Ohio $84 - $235 79%
Aetna $95 - $203 89%
Blue Cross Blue Shield $95 - $214 89%
Cigna $95 - $219 89%
Devoted Health $95 89%
Humana $95 89%
Molina $95 89%
Primetime Health Plan $95 89%
Summacare $95 - $216 89%
The Health Plan $95 - $209 89%
UnitedHealthcare $95 - $219 89%
Wellcare By Allwell $95 89%
Paramount $98 92%
Perennial Advantage Of Ohio $100 94%
Valor Health Plans $100 94%
Amish Aid Community Plan $109 102%
Amish Church Fund And Workers Aid Plan $109 102%
Buckeye Plain Ministries $109 102%
Christian Healthcare Ministries $118 110%
Immergrun $118 110%
Sunrise Plain Communities $118 110%
University Health Employee Plan (Contigo) $161 151%
Medical Mutual Traditional/Health Ohio $166 155%
Ambetter / Centene $171 160%
Caresource $171 160%
Beech Street $190 - $213 178%
Ohio Preferred Network $190 - $213 178%
First Health $197 184%
Century Health Network $201 188%
Ohio Health Choice $201 - $213 188%
Private Healthcare System $204 191%
Aultcare $213 199%
Clarity $213 199%
Configurenet $213 199%
Fortified Provider Network $213 199%
Healthsmart $213 199%
Jp Farley $213 199%
Multiplan $213 199%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1025 Center St, Ashland, OH 44805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals