CMS Price Transparency Data

X-ray, pelvis

Facility: Saint Alphonsus Medical Center Ontario

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $30
  • Cash Discount Price: $134
  • vs. Medicare Baseline: 0.28x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Saint Alphonsus Medical Center Ontario is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $134. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.28x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$134

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $134 (125%)
Insurance Median: $30 (28%)
Cash: $134 (125% of Medicare)
Ins. Median: $30 (28% 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
Medicaid / KanCare $5 - $104 5%
Aetna $7 - $327 7%
Albany County Correctional Facility $7 - $30 7%
Ambetter / Centene $7 - $104 7%
Amish Mennonite $7 - $104 7%
Ascension St. Vincent Public Safety Medical $7 - $30 7%
Bcccp-Michigan $7 - $104 7%
Bccp $7 - $104 7%
Blue Cross Blue Shield $7 - $312 7%
Bmc Healthnet $7 - $104 7%
Breast Grant-Connecticut $7 - $104 7%
Broward County Dept Of Health $7 - $30 7%
California Health And Wellness $7 - $104 7%
Can Community Health Inc $7 - $30 7%
Cardinal Innovations Lme $7 - $104 7%
Care Connections Of Northern Iowa $7 - $30 7%
Care Oregon Ohp $7 - $104 7%
Cencal Health Plan $7 - $104 7%
Cenpatico $7 - $104 7%
Centurion Of Idaho $7 - $104 7%
Chhuny $7 - $104 7%
Childrens Comm Health Plan $7 - $104 7%
Childrens Medical Services Title 19 $7 - $104 7%
Cigna $7 - $324 7%
City Of Philadelphia $7 - $30 7%
Cmh Allegan County $7 - $30 7%
Cmh Ausable Valley $7 - $30 7%
Cmh Barry County $7 - $30 7%
Cmh Bay-Arenac County $7 - $30 7%
Cmh Berrien County $7 - $30 7%
Cmh Cass County $7 - $30 7%
Cmh Central Mi County $7 - $30 7%
Cmh Clinton-Eaton-Ingham County $7 - $30 7%
Cmh Detroit Wayne Integrated Health Network $7 - $30 7%
Cmh Genesee County $7 - $30 7%
Cmh Ionia County $7 - $30 7%
Cmh Jackson County/Lifeways $7 - $30 7%
Cmh Kalamazoo $7 - $30 7%
Cmh Kent County $7 - $30 7%
Cmh Lenawee County $7 - $30 7%
Cmh Livingston County $7 - $30 7%
Cmh Macomb $7 - $30 7%
Cmh Misc $7 - $30 7%
Cmh Monroe County $7 - $30 7%
Cmh Montcalm County $7 - $30 7%
Cmh Muskegon County $7 - $30 7%
Cmh Newaygo County $7 - $30 7%
Cmh North Country $7 - $30 7%
Cmh Northern Lakes County $7 - $30 7%
Cmh Oakland County $7 - $30 7%
Cmh Ottawa County $7 - $30 7%
Cmh Van Buren County $7 - $30 7%
Cmh Washtenaw County $7 - $30 7%
Cmh Wayne County/Carelink $7 - $30 7%
Cmh Wayne Cty/Com Liv Svcs $7 - $30 7%
Cmh West Mi County $7 - $30 7%
Community Benefit Health $7 - $104 7%
Community Care Behavorial Health $7 - $104 7%
Community Care Partners $7 - $30 7%
Community Health Choice $7 - $104 7%
Connections Csp $7 - $30 7%
County Coroner $7 - $30 7%
County Funding Generic $7 - $30 7%
Covid19 Hrsa Uninsured Testing And Treatment Fund $7 - $104 7%
Dean Wi Badgercare $7 - $104 7%
Delaware County Department Of Health $7 - $30 7%
Delaware First Health $7 - $104 7%
Delta Dental Nj $7 - $104 7%
Dph Tb Program $7 - $104 7%
Dscc $7 - $104 7%
Eastpointe Lme $7 - $104 7%
Family Health Network $7 - $104 7%
Freedom First Healthcare $7 - $104 7%
Fresno County Ccs $7 - $30 7%
Ghc Scw Wi Badgercare $7 - $104 7%
Harbor Health $7 - $104 7%
Health Safety Net $7 - $104 7%
Healthy Blue Ne $7 - $104 7%
Hennepin Health $7 - $104 7%
Humana $7 - $304 7%
Id County Ada $7 - $104 7%
Id County Canyon $7 - $104 7%
Id County Cat Fund $7 - $104 7%
Id County Other $7 - $30 7%
Id County Payette $7 - $104 7%
Idaho Dept Health And Wellfare $7 - $30 7%
Idaho Womens Health Check $7 - $104 7%
Indiana Breast Cervical Cancer $7 - $104 7%
Inland Empire Health Plan $7 - $104 7%
Intercommunity Health Ohp $7 - $104 7%
Iowa Total Care $7 - $104 7%
Jai Medical System $7 - $104 7%
Kern Family Health Plan $7 - $104 7%
Keystone First $7 - $104 7%
Keystone First Chip $7 - $104 7%
La Care Health Plan $7 - $104 7%
Lakeland Care Inc $7 - $104 7%
Managed Health Services - Indiana $7 - $104 7%
Maryland Breast & Cervical Program $7 - $104 7%
Maryland Healthy Smiles - Scion Dental $7 - $104 7%
Maryland Physicians Care $7 - $104 7%
Massachusetts Behavioral Health Partnership $7 - $104 7%
Mdwise $7 - $104 7%
Medi-Cal $7 - $104 7%
Medi-Cal Healthnet $7 - $104 7%
Medstar Dc Healthy Family $7 - $104 7%
Medstar Md Health Choice $7 - $104 7%
Mo Home State Health Plan $7 - $104 7%
Molina Centennial Care $7 - $104 7%
Nascentia Health Options $7 - $104 7%
Nebraska Total Care $7 - $104 7%
New York Cancer Services Program $7 - $104 7%
Nextlevel Health $7 - $104 7%
Oregon Screenwise $7 - $104 7%
Pace Of Southwest Michigan $7 - $104 7%
Paramount Advantage $7 - $104 7%
Parkland Community Health Plan $7 - $104 7%
Partners Behavioral Lme $7 - $104 7%
Peach State Healthplan $7 - $104 7%
Philadelphia County Funding $7 - $30 7%
Presbyterian Centennial Care $7 - $104 7%
Prestige Health Choice $7 - $104 7%
Priority Partners $7 - $104 7%
Robert F Sing Program $7 - $30 7%
Rx 340B Pass Along $7 - $104 7%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $7 - $104 7%
Rx Medi-Cal $7 - $104 7%
Rx Meridian Rx $7 - $104 7%
Ryan White Florida Mssrp $7 - $30 7%
Sandhills Center Lme $7 - $104 7%
Screening For Life $7 - $104 7%
St Joseph County Hlth Dpt $7 - $30 7%
Stephenson Cty Health $7 - $30 7%
Sunshine State Health Plan $7 - $104 7%
Superior Health $7 - $104 7%
Tenncare $7 - $104 7%
Texas Children'S Health Plan $7 - $104 7%
Trillium Community Ohp $7 - $104 7%
Tufts Health Public Plans $7 - $104 7%
UnitedHealthcare $7 - $331 7%
Vaya Health Lme $7 - $104 7%
Washtenaw Health Plan $7 - $30 7%
Wellsense Health Plan $7 - $104 7%
Wi Womens Wellness $7 - $104 7%
Align Senior Care $8 - $37 7%
Ally Align Care Adv $8 - $37 7%
American Health Advantage Of Idaho $8 - $127 7%
American Health Plan $8 - $37 7%
Aurora Special Needs $8 - $37 7%
Blue Care Network Advantage $8 - $37 7%
Blue Shield - De (Highmark) Medciare Advantage $8 - $37 7%
Care Dimensions $8 - $37 7%
Care Improvement Plus $8 - $37 7%
Care Resources Pace $8 - $37 7%
Careplus Health Plans $8 - $37 7%
Cca - Zing Health $8 - $37 7%
Cca Senior Care Options $8 - $37 7%
Central Valley Medical Services Corp Pace $8 - $37 7%
Champion Health Plan Mcr Advantage $8 - $37 7%
Champva $8 - $35 7%
Clear Spring Health $8 - $37 7%
Clover Health $8 - $37 7%
Commonwealth Care Alliance $8 - $37 7%
Community Pace At Home $8 - $37 7%
Eddy Senior Care-Pace $8 - $37 7%
Eddy Seniorcare Pace $8 - $37 7%
Elementcare $8 - $37 7%
Evercare $8 - $37 7%
Everence $8 - $37 7%
Gateway Health Plan $8 - $37 7%
Genesys Pace Of Genesee County $8 - $37 7%
Georgia Health Advantage $8 - $37 7%
Gold Advantage $8 - $37 7%
Gpa Croell Redi Mix $8 - $37 7%
Health America Advantra $8 - $37 7%
Highmark Health Options Dual Plan $8 - $37 7%
Hope Select Pace $8 - $37 7%
Horizon Nj Total Care $8 - $37 7%
Hudson Headwaters Pace $8 - $37 7%
Huron Valley Pace $8 - $37 7%
Innovative Integrated Health Community Plans $8 - $37 7%
Iowa Health Advantage $8 - $37 7%
Johns Hopkins Advantage Md $8 - $37 7%
Lasso Healthcare Msa $8 - $37 7%
Life St Marys Pace $8 - $37 7%
Lifecircles Pace $8 - $37 7%
Longevity Health Plan $8 - $37 7%
Longevity Ipa Of Michigan Llc Health Plan Isnp $8 - $37 7%
Martins Point Generations Advantage $8 - $37 7%
Mass General Brigham Mcr Adv $8 - $37 7%
Medicare (plans) $8 - $131 7%
Medipak Advantage $8 - $37 7%
Mercy Life $8 - $37 7%
Mercyone Cedar Valley $8 - $37 7%
Meridian Complete $8 - $37 7%
Michigan Complete Health $8 - $37 7%
Nascentia Health Plus $8 - $37 7%
New Centry Health Careplus $8 - $37 7%
Osu Prime Care Advantage $8 - $37 7%
Pace Cny $8 - $37 7%
Pace Iowa Immanuel Pathways $8 - $37 7%
Pace Southeast $8 - $37 7%
Pace-Trinity Health $8 - $37 7%
Peak Pace Solutions $8 - $37 7%
Perennial Advantage $8 - $37 7%
Preferred Care Partners $8 - $37 7%
Presbyterian Senior Plan $8 - $37 7%
Provider Partners Health Plan Of Illinois $8 - $37 7%
Provider Partners Health Plan Of Indiana $8 - $37 7%
Pruitthealth Premier $8 - $37 7%
Reliance Community Care Partners Care Resources Pace $8 - $37 7%
Rx Allwin $8 - $37 7%
Rx Grane Grnmedd $8 - $37 7%
Rx Retiree Rx Care $8 - $37 7%
Scan Health Plan Mcr Ipa Meritage Oon $8 - $37 7%
Secure Horizons Ma Pffs $8 - $37 7%
Serenity Pace $8 - $37 7%
Siouxland Pace $8 - $37 7%
Solis Health Plans $8 - $37 7%
Sunnyview-Pace Finance Dept $8 - $37 7%
Texan Plus $8 - $37 7%
The Health Plan $8 - $37 7%
Thome Pace $8 - $37 7%
Todays Options $8 - $37 7%
Tribute Health Plans $8 - $37 7%
Tricare $8 - $35 7%
Triwest Health Alliance $8 - $35 7%
Um Health Advantage $8 - $37 7%
Union Health Service $8 - $37 7%
Us Family Health Plan $8 - $35 7%
Veterans Administration $8 - $37 7%
Veterans Eval Services $8 - $35 7%
Welbe Health $8 - $37 7%
Wellmed $8 - $37 7%
Webtpa $14 - $329 13%
Providence $15 - $328 14%
Bcn Domestic $16 - $71 15%
Blue Benefit Administrators Of Massachusetts $16 - $312 15%
Blue Care Network $16 - $312 15%
Blue Distinction Transplant $16 - $312 15%
Blue Shield - Ca $16 - $312 15%
Blue Shield - Ny Highmark Northeastern $16 - $312 15%
Blue Shield - Ny Highmark Western $16 - $312 15%
Blue Shield - Pa (Highmark) $16 - $312 15%
Blue Shield - Wa (Regence) $16 - $312 15%
Health Choices $16 - $71 15%
Kaiser Domestic $16 - $71 15%
Molina Marketplace $16 - $73 15%
Pacificsource Health Plans $16 - $324 15%
Pre-Employment $16 - $71 15%
Wc Domestic $16 - $71 15%
Asuris Northwest Health $17 - $78 16%
Blue Shield - Id (Regence) $17 - $312 16%
Geha $17 - $331 16%
Healthcare Management Admin $17 - $321 16%
Moda Health $17 - $335 16%
Health Plans Inc $18 - $74 17%
Ms Administrative Services $18 - $74 17%
Healthnet $19 - $290 18%
St Lukes Health Plan $20 - $121 19%
Allied Benefit Systems $21 - $327 20%
Asr Health Benefits $21 - $327 20%
Boon Chapman $21 - $91 20%
Christian Brother Services $21 - $327 20%
First Choice Health $21 - $310 20%
Healthscope $21 - $91 20%
Luminare Health (Detroit) $21 - $327 20%
Meritain $21 - $91 20%
Mountain Health Co-Op $21 - $207 20%
Rural Carrier Health Benefit Plan $21 - $327 20%
Selecthealth $21 - $310 20%
Allegiance $22 - $262 21%
Allied National Global Care $22 - $310 21%
Andrie Inc $22 - $99 21%
Asrm - Reliance Standard Life Insurance $22 - $310 21%
Christian Care Ministry $22 - $310 21%
Dean Health $22 - $310 21%
East Greenbush Central School District $22 - $99 21%
Fallon Health $22 - $310 21%
Family Life Insurance Company $22 - $310 21%
Genex Wc $22 - $99 21%
Ghc Scw $22 - $310 21%
Healthsmart Workers Comp $22 - $99 21%
International Benefit Administrators $22 - $310 21%
Jag Source $22 - $99 21%
Lifetime Benefit Solutions $22 - $310 21%
Manhattan Life $22 - $310 21%
Medi Share $22 - $328 21%
Multiplan $22 - $124 21%
New York State Insurance Fund $22 - $99 21%
Njm Insurance Group $22 - $99 21%
Pai $22 - $310 21%
Pan-American Life $22 - $310 21%
Paramount Hmo $22 - $310 21%
Phcs $22 - $310 21%
Rx Heatlhcomp $22 - $99 21%
Rx Restat $22 - $99 21%
Rx Saif Opdp Wc $22 - $99 21%
Rx Worker'S Comp $22 - $99 21%
Trinity Health Share $22 - $310 21%
Wc Accident Fund $22 - $99 21%
Wc Ace $22 - $99 21%
Wc Acs Federal Employees $22 - $99 21%
Wc Acuity $22 - $99 21%
Wc Advantage $22 - $99 21%
Wc Aegis $22 - $99 21%
Wc Aig $22 - $99 21%
Wc Aims $22 - $99 21%
Wc Alaska National Ins $22 - $99 21%
Wc Align Network $22 - $99 21%
Wc Allied $22 - $99 21%
Wc Am Trust N America $22 - $99 21%
Wc American Claims Mgmt $22 - $99 21%
Wc Amerisure $22 - $99 21%
Wc Amtrust $22 - $99 21%
Wc Asu Risk Mgt $22 - $99 21%
Wc Benetech $22 - $99 21%
Wc Berkley Admin $22 - $99 21%
Wc Broadspire $22 - $99 21%
Wc Broward County $22 - $99 21%
Wc Bunch & Associates $22 - $99 21%
Wc California State Comp Ins $22 - $99 21%
Wc California State Ins Fund $22 - $99 21%
Wc Capitol Area Health Consortium $22 - $99 21%
Wc Ccmsi $22 - $99 21%
Wc Chartis $22 - $99 21%
Wc Chubb $22 - $99 21%
Wc Cirma $22 - $99 21%
Wc City Of Albany $22 - $99 21%
Wc City Of Sioux City $22 - $99 21%
Wc Claims Mgmt Inc $22 - $99 21%
Wc Cna $22 - $99 21%
Wc Comp One Admin C/O Manageability $22 - $99 21%
Wc Compone Admin $22 - $99 21%
Wc Corvel $22 - $99 21%
Wc Ct Healthcare Trust $22 - $99 21%
Wc Donegal Insurance Group $22 - $99 21%
Wc Emc Insurance Company $22 - $99 21%
Wc Employee Mutual $22 - $99 21%
Wc Enablecomp $22 - $99 21%
Wc Encore Health Network $22 - $99 21%
Wc Erie $22 - $99 21%
Wc Esis $22 - $99 21%
Wc Evolutions $22 - $99 21%
Wc Fcci $22 - $99 21%
Wc Fed Ex $22 - $99 21%
Wc Federal Black Lung $22 - $99 21%
Wc Federated $22 - $99 21%
Wc Finley Occupational Health $22 - $99 21%
Wc First Agency/Occunet $22 - $99 21%
Wc Ford Motor $22 - $99 21%
Wc Fresno Unified Emp $22 - $99 21%
Wc Gallagher Bassett $22 - $99 21%
Wc General Motors $22 - $99 21%
Wc Generic $22 - $99 21%
Wc Genex Care For Ohio $22 - $99 21%
Wc Great West Casualty $22 - $99 21%
Wc Guarantee Insurance $22 - $99 21%
Wc Guard Insurance Company $22 - $99 21%
Wc Hab $22 - $99 21%
Wc Hartford $22 - $99 21%
Wc Hastings $22 - $99 21%
Wc Health Management $22 - $99 21%
Wc Heritage Summit $22 - $99 21%
Wc Hireright $22 - $99 21%
Wc Horizon $22 - $99 21%
Wc Icw Group $22 - $99 21%
Wc Idaho State Ins Fund $22 - $99 21%
Wc Intercare Insurance $22 - $99 21%
Wc Intermountain $22 - $99 21%
Wc Johns Eastern $22 - $99 21%
Wc Kemberton $22 - $99 21%
Wc Key Ins & Benefit Solutions $22 - $99 21%
Wc Liberty Mutual $22 - $99 21%
Wc Mac Risk Management $22 - $99 21%
Wc Massachusetts $22 - $99 21%
Wc Mdia $22 - $99 21%
Wc Meadowbrook Claim $22 - $99 21%
Wc Medical Administrators $22 - $99 21%
Wc Meijers $22 - $99 21%
Wc Memic $22 - $99 21%
Wc Mercy Workcare $22 - $99 21%
Wc Michigan $22 - $99 21%
Wc Michigan Millers Mutual $22 - $99 21%
Wc Mitchell Frankenmuth $22 - $99 21%
Wc Mra $22 - $99 21%
Wc Nationwide $22 - $99 21%
Wc Nca Comp $22 - $99 21%
Wc New York $22 - $99 21%
Wc New York Special Funds $22 - $99 21%
Wc North American Rishces $22 - $99 21%
Wc Northeast Health $22 - $99 21%
Wc Notre Dame $22 - $99 21%
Wc Novanet $22 - $99 21%
Wc O'Hara Corp $22 - $99 21%
Wc Occ Health Allen $22 - $99 21%
Wc Ohio Bureau $22 - $99 21%
Wc One Call Medical $22 - $99 21%
Wc Paradigm $22 - $99 21%
Wc Peerless $22 - $99 21%
Wc Pma $22 - $99 21%
Wc Praxis Health Network $22 - $99 21%
Wc Price Chopper $22 - $99 21%
Wc Procura Management $22 - $99 21%
Wc Qualcare $22 - $99 21%
Wc Quiktrip $22 - $99 21%
Wc Reny Company $22 - $99 21%
Wc Rev Claims $22 - $99 21%
Wc Risico $22 - $99 21%
Wc Rural Mutual $22 - $99 21%
Wc Saif Oregon $22 - $99 21%
Wc Secura $22 - $99 21%
Wc Sedgwick $22 - $99 21%
Wc Sentry $22 - $99 21%
Wc Sheakley Unicomp $22 - $99 21%
Wc Smile Lodge $22 - $99 21%
Wc Society $22 - $99 21%
Wc Srs $22 - $99 21%
Wc Taconic (Mro) $22 - $99 21%
Wc Taconic Farms $22 - $99 21%
Wc Travelers $22 - $99 21%
Wc Triad Group $22 - $99 21%
Wc Tristar $22 - $99 21%
Wc Troy Ny $22 - $99 21%
Wc Tyson $22 - $99 21%
Wc Unified Health Services $22 - $99 21%
Wc United Heartland $22 - $99 21%
Wc Us Dept Of Labor $22 - $99 21%
Wc Velocity $22 - $99 21%
Wc Walmart $22 - $99 21%
Wc West Bend $22 - $99 21%
Wc West Bend Mutual/Argent $22 - $99 21%
Wc Winnebago Industries $22 - $99 21%
Wc Yankee Trails $22 - $99 21%
Wc York Risk $22 - $99 21%
Wc Zenith $22 - $99 21%
Wc Zurich $22 - $99 21%
Ada County Jail Inmate Ins $104 97%
Correctional Health Partners $269 252%
Columbia Health Network $276 258%
Lifewise $321 301%
Priority Health $324 303%
Ameriben $327 306%
Healthez $327 306%
First Health $328 307%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 351 Sw 9Th Street, Ontario, OR 97914
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals