CMS Price Transparency Data

X-ray, pelvis

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $50
Cash Discount Price: $72
vs. Medicare Baseline: 0.47x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Cincinnati Children's Hospital Medical Center is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.47x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$50

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: $72 (67%)

Insurance Median: $50 (47%)

Cash: $72 (67% of Medicare)

Ins. Median: $50 (47% 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
Aetna	$5 - $212	5%
Blue Cross Blue Shield	$6 - $219	6%
Caresource_In	$6 - $19	6%
Humana	$6 - $89	6%
Mhs_In	$6 - $18	6%
Passport_Ky	$6 - $58	6%
United_Health_Care_Ky	$6 - $59	6%
Wellcare_Ky	$6 - $59	6%
Amerihealth_Caritas_Oh	$11 - $92	10%
Caresource_Oh	$11 - $85	10%
Buckeye_Oh	$12 - $97	11%
Molina_Oh	$12 - $93	11%
United_Health_Care_Oh	$13 - $89	12%
Caresource_Oh_Insurance	$29 - $107	27%
Medical_Mutual_Of_Ohio_Insurance	$32 - $212	30%
Parkview_Signature_Care_Insurance	$37 - $174	35%
Point_Comfort_Insurance	$39 - $145	37%
Margaret_Mary_Health_Insurance	$40 - $174	37%
United_Health_Care_Insurance	$46 - $200	43%
Beechstreet_Insurance	$48 - $219	45%
Cigna	$48 - $212	45%
Health_Ohio_Network_Insurance	$55 - $212	51%
Custom_Design_Benefits_Insurance	$57 - $212	53%
Health_Smart_Preferred_Insurance	$57 - $212	53%
Medical_Benefit_Administrators_Insurance	$57 - $212	53%
Ohio_Health_Choice_Insurance	$57 - $212	53%
Private_Health_Care_Systems_Insurance	$58 - $214	54%
First_Health_Group_Insurance	$59 - $219	55%
Health_Link_Insurance	$59 - $219	55%
Evolutions_Health_Care_Systems	$60 - $223	56%
Galaxy_Health_Insurance	$60 - $223	56%

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 $72.
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 Cincinnati Children's Hospital Medical Center 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.