CMS Price Transparency Data

X-ray, pelvis

Facility: Ohio Valley Surgical Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $275
  • Cash Discount Price: $184
  • vs. Medicare Baseline: 2.57x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Ohio Valley Surgical Hospital is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $184. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.57x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$184

Average discount available for prompt cash payment at this facility.

Insurance Median
$275

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: $184 (172%)
Insurance Median: $275 (257%)
Cash: $184 (172% of Medicare)
Ins. Median: $275 (257% 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 257% of the Medicare baseline (a markup of 157%). 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
Aetna $32 - $20,896 30%
Geha $32 - $20,896 30%
Genworth $32 - $20,896 30%
Mail Handlers $32 - $20,896 30%
Meritain $32 - $20,896 30%
Meritain Heatlh $32 - $20,896 30%
Mhbp $32 - $20,896 30%
Ngs Coresource $32 - $20,896 30%
Nippon Life $32 - $20,896 30%
Pacific Source $32 - $20,896 30%
Personify Health $32 - $20,896 30%
Aarp $101 - $11,885 95%
Aarp Supplemental $101 - $11,885 95%
American Continental Insurance $101 - $11,885 95%
American Continental Life $101 - $11,885 95%
American Republic $101 - $11,885 95%
American Retirement $101 - $11,885 95%
Aultcare Primetime Health Plan $101 - $11,885 95%
Bankers Fidelity $101 - $11,885 95%
Bankers Life And Casualty $101 - $11,885 95%
Blue Cross Blue Shield $101 - $40,293 95%
Central States $101 - $11,885 95%
Champus $101 - $11,885 95%
Cigna $101 - $18,817 95%
Communicare Advantage $101 - $11,885 95%
Everest $101 - $11,885 95%
Gateway Health Plan $101 - $11,885 95%
Humana $101 - $11,919 95%
Medicare (plans) $101 - $12,264 95%
Medigold $101 - $11,885 95%
Mmoh $101 - $11,885 95%
Molina $101 - $11,885 95%
Molina Dual Mcr $101 - $11,885 95%
Molina Marketplace $101 - $11,885 95%
Molina Dual Mcr $101 - $11,885 95%
Molina Mcr $101 - $11,885 95%
Molina Mcr Mcd $101 - $11,885 95%
Molina Mcr+Mcd $101 - $11,885 95%
Patient No Pay $101 - $11,885 95%
Prosperity Supplement $101 - $11,885 95%
UnitedHealthcare $101 - $17,571 95%
Wellcare By Allwell $101 - $11,885 95%
Wraparound Pl Supp $101 - $11,885 95%
The Health Plan $106 - $12,479 99%
Employer Direct $117 - $15,703 110%
Devoted Health $120 - $13,707 112%
Mmo Cin. Hmo $141 - $193 132%
Mmoh (Supermed) $141 - $142 132%
Caresource $152 - $17,827 142%
Caresourse $152 - $17,827 142%
Medicaid / KanCare $152 - $17,827 142%
Healthgram $164 - $18,817 154%
Nalc $164 - $18,817 154%
Samba $164 - $18,817 154%
Sbma $164 - $18,817 154%
Unified Group $164 - $18,817 154%
Self Pay Imaging $175 - $11,885 164%
Golden Rule $178 - $17,571 167%
Medica $178 - $17,571 167%
Oxford $178 - $17,571 167%
Shl $178 - $17,571 167%
Surest $178 - $17,571 167%
Ushealth $178 - $17,571 167%
Luminare Health $275 257%
Medben $275 257%
Ohio Health $275 257%
Preferred Health $275 257%
Amerihealth Caritas Of Ohio $3,657 3424%
Buckeye Community Health Plan $4,022 3766%
Molina Mcd $4,084 3824%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals