CMS Price Transparency Data

X-ray, pelvis

Facility: Hillcrest Hospital South

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $380
Cash Discount Price: $260
vs. Medicare Baseline: 3.56x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Hillcrest Hospital South is $380. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.56x the Medicare baseline. Located in 8801 South 101St East Avenue, Tulsa, OK.

Cash / Self-Pay

$260

Average discount available for prompt cash payment at this facility.

Insurance Median

$380

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: $260 (243%)

Insurance Median: $380 (356%)

Cash: $260 (243% of Medicare)

Ins. Median: $380 (356% 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 356% of the Medicare baseline (a markup of 256%). 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
Healthcare Highways [2210]	$216 - $372	202%
Hooray Health [8000]	$216	202%
Oncology Patient Assistance Programs [2295]	$216	202%
Oscar Insurance Company [7005]	$216	202%
Osma Health Network [2345]	$216	202%
Healthscope Benefits [2290]	$306	286%
UnitedHealthcare	$306	286%
Cigna	$341	319%
National Association Of Letter Carriers [1695]	$341	319%
Pba [1775]	$341	319%
Resource One Administrators [2815]	$372	348%
Web Tpa [2115]	$372 - $380	348%
Aetna	$380	356%
Coresource [1315]	$380	356%
Coventry Healthcare [1320]	$380	356%
Meritain Health [1655]	$380	356%
The Kempton Group Administrators [2905]	$389	364%
Medica [2910]	$509	477%
Multiplan [1680]	$509 - $692	477%
Community Care [1290]	$649	608%
Employee Benefit Management Services [2445]	$649	608%
Phcs [1780]	$649 - $692	608%
Administrative Concepts [1005]	$692	648%
Allied Benefit Systems Inc [1030]	$692	648%
Allied National Global Care [1035]	$692	648%
Healthcost Solutions [2415]	$692	648%
Healthfirst [2395]	$692	648%
Hometown Health [2155]	$692	648%
Mayo Clinic Health Solutions [2280]	$692	648%
Mutual Of Omaha [1685]	$692	648%
New Era Life Insurance Company [1705]	$692	648%
Pan American Life Insurance Co [1770]	$692	648%
Planned Administrators Inc [2360]	$692	648%
Trustmark [2030]	$692	648%
Universal Fidelity [2085]	$692	648%

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 $260.
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 South 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.