CMS Price Transparency Data

X-ray, pelvis

Facility: Licking Memorial Hospital

Billing Code: 72170 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$104

about 1.0× the $107 Medicare rate · typically $87–$213

modeled estimate · not a bill or quote

What this hospital charges insurers

$101

About the fair price

about $3 under the fair price · 0.9× Medicare

Medicare pays $107 Fair price $104 This hospital $101 Cash price $508 Hospital's list price $508

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

Highest price of the 9 OH hospitals we have prices for — worth calling around.

Cheapest $25 Priciest $101

Black dot = this hospital, among the 9 OH hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a X-ray, pelvis is about $104 (about 1.0× the $107 Medicare rate). Licking Memorial Hospital charges insurers about $101, or about $508 in cash — about the fair price. Located in Newark, OH.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$101 - $432	95%
Blue Cross Blue Shieldmajor	$101 - $437	95%
Aetnamajor	$101 - $469	95%
Cignamajor	$101 - $458	95%
Humanamajor	$101 - $493	95%
GEHA	$416	389%
Medical Mutual	$280 - $422	262%
Molina	$161	151%
Sentara	$416	389%
WellCare	$101	95%
+ 26 smaller / regional plans	$356 - $508

Government programs also on file: Medicare, Military & VA.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 508), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72170.

Insurance Before you use insurance

Call your insurance company to confirm Licking Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 72170.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Licking Memorial Hospital

Compare: X-ray, pelvis at other OH hospitals

Insurance negotiated median for the same procedure, sorted lowest first.