CMS Price Transparency Data

X-ray, pelvis

Facility: Fostoria Community Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $188
Cash Discount Price: $230
vs. Medicare Baseline: 1.76x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Fostoria Community Hospital is $188. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $230. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.76x the Medicare baseline. Located in 501 Van Buren Street, Fostoria, OH.

Cash / Self-Pay

$230

Average discount available for prompt cash payment at this facility.

Insurance Median

$188

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: $230 (215%)

Insurance Median: $188 (176%)

Cash: $230 (215% of Medicare)

Ins. Median: $188 (176% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Paramount Health Care	$25 - $188	23%
Blue Cross Blue Shield	$26 - $464	24%
Health Alliance Plan	$26 - $266	24%
Health Value Management	$26 - $77	24%
Buckeye Community Health Plan	$27 - $84	25%
Buckeye Community Health Plan Inc	$29 - $128	27%
Aetna	$30 - $237	28%
Dayton Area Health Plan Dba Caresource	$41 - $147	38%
Meridian Health Plan Of Mi	$57	53%
Veterans Affairs	$78	73%
UnitedHealthcare	$84 - $212	79%
Amerihealth	$88	82%
Medical Mutual Of Ohio	$200 - $213	187%
Frontpath Health Coalition	$204	191%
Ohio Health Choice	$230	215%
Ohio Ppo Connect	$230 - $266	215%
Health Ohio Network	$280	262%
Connecticut General Life Insurance Company	$282	264%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $230.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72170.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fostoria Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72170.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.