CMS Price Transparency Data

X-ray, pelvis

Facility: Mid-Columbia Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $124
  • Cash Discount Price: $92
  • vs. Medicare Baseline: 1.16x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Mid-Columbia Medical Center is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.16x the Medicare baseline. Located in 1700 E 19Th Street, The Dalles, OR.
Cash / Self-Pay
$92

Average discount available for prompt cash payment at this facility.

Insurance Median
$124

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: $92 (86%)
Insurance Median: $124 (116%)
Cash: $92 (86% of Medicare)
Ins. Median: $124 (116% 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.

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
Blue Cross Blue Shield $8 - $1,024 7%
Community Hp Mcr Adv - All Plans $8 - $124 7%
Healthnet Mcr Adv $8 - $127 7%
Humana $8 - $131 7%
Moda Mcr Adv $8 - $124 7%
Molina Mcr Adv $8 - $124 7%
Tricare $8 - $124 7%
Va Ccn Triwest - All Plans $8 - $124 7%
Devoted Mcr Adv - All Plans $9 - $347 8%
Employee Health Plan - All Plans $9 - $224 8%
Molina - All Other Plans $9 - $137 8%
Aetna $10 - $296 9%
Healthnet - All Other Plans $12 11%
Cigna $14 - $303 13%
Multiplan/Phcs - All Plans $14 - $305 13%
Coventry - All Plans $16 - $289 15%
First Choice - All Plans $16 - $305 15%
Providence Ppo - All Plans $16 - $305 15%
Moda Health Plan - All Other Plans $17 - $212 16%
Molina Mcaid $33 - $167 31%
Amerigroup Mcaid - All Plans $63 - $167 59%
Coordinated Care Mcaid - All Plans $63 - $167 59%
Norocor - All Plans $161 151%
UnitedHealthcare $167 - $305 156%
Healthscape - All Plans $257 241%
First Health - All Plans $286 268%
Pacific Source - All Plans $295 276%
Trpn - Three Rivers - All Plans $305 286%
Ahp - Americas Hlth Plan - All Plans $312 292%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 E 19Th Street, The Dalles, OR 97058
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals