CMS Price Transparency Data

X-ray, pelvis

Facility: Hillcrest Hospital Henryetta

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $728
Cash Discount Price: $273
vs. Medicare Baseline: 6.82x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Hillcrest Hospital Henryetta is $728. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $273. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.82x the Medicare baseline. Located in 2401 W Main, Henryetta, OK.

Cash / Self-Pay

$273

Average discount available for prompt cash payment at this facility.

Insurance Median

$728

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: $273 (256%)

Insurance Median: $728 (682%)

Cash: $273 (256% of Medicare)

Ins. Median: $728 (682% 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 682% of the Medicare baseline (a markup of 582%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Black Lung [6055]	$228	213%
Lucent Health [6000]	$228	213%
Aetna	$399	374%
Coresource [1315]	$399	374%
Coventry Healthcare [1320]	$399	374%
Meritain Health [1655]	$399	374%
Cigna	$499	467%
Healthpartners [1500]	$499	467%
National Association Of Letter Carriers [1695]	$499	467%
Pba [1775]	$499	467%
Global Health [1430]	$564	528%
First Health [1375]	$617 - $783	578%
Multiplan [1680]	$617 - $783	578%
Healthcare Solutions [1485]	$646	605%
Community Care [1290]	$728	682%
Fmh Benefit Services [1390]	$728	682%
Group Resources [1455]	$728	682%
Phcs [1780]	$728 - $783	682%
Healthsmart [1505]	$774	725%
Administrative Concepts [1005]	$783	733%
Allied Benefit Systems Inc [1030]	$783	733%
Allied National Global Care [1035]	$783	733%
Gilsbar [1425]	$783	733%
Healthnet [1495]	$783	733%
New Era Life Insurance Company [1705]	$783	733%
Pan American Life Insurance Co [1770]	$783	733%
Trustmark [2030]	$783	733%
Pending Ssi [1616]	$910	852%

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 $273.
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 Hillcrest Hospital Henryetta 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.