CMS Price Transparency Data

X-ray, pelvis

Facility: Union Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $52
  • Cash Discount Price: $441
  • vs. Medicare Baseline: 0.49x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Union Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.49x the Medicare baseline. Located in 659 Boulevard, Dover, OH.
Cash / Self-Pay
$441

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $441 (413%)
Insurance Median: $52 (49%)
Cash: $441 (413% of Medicare)
Ins. Median: $52 (49% 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
Summacare $5 - $527 5%
Aetna $8 - $753 7%
Aultcare $8 - $306 7%
Blue Cross Blue Shield $8 - $362 7%
Cigna $8 - $306 7%
Communicare $8 - $103 7%
Humana $8 - $98 7%
Mmo $8 - $527 7%
The Health Plan $8 - $584 7%
United $8 - $335 7%
Valor $8 - $98 7%
Cc Ehp $9 - $507 8%
Perennial Health $9 - $106 8%
Pphp $9 - $108 8%
Zing Health $9 - $108 8%
Oscar $20 - $261 19%
Buckeye $21 - $50 20%
Molina $21 - $52 20%
Caresource $22 - $50 21%
Amerihealth $23 - $55 22%
Ohcp $29 - $330 27%
Omas $37 - $376 35%
Healthsmart $41 - $414 38%
Phphi $44 - $452 41%
Upmc $44 - $452 41%
Gms $52 - $527 49%
Consociate Health $56 - $565 52%
Multiplan $67 - $678 63%
UnitedHealthcare $95 - $98 89%
Devoted Health $98 92%
Amish Community Aid Plan $306 - $340 286%
Ohio Healthy $367 344%
Php $407 381%
Medical Benefit Corp $475 445%
Frontpath $611 572%
Managed Care Services $611 572%
Tertiary Care Network $611 572%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 659 Boulevard, Dover, OH 44622
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals