CMS Price Transparency Data

X-ray, pelvis

Facility: Santiam Hospital & Clinics

Billing Code: 72170 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$104

about 1.0× the $107 Medicare rate · typically $97–$117

modeled estimate · not a bill or quote

What this hospital charges insurers

$117

About the fair price

about $13 over the fair price · 1.1× Medicare

Medicare pays $107 Fair price $104 This hospital $117 Cash price $260 Hospital's list price $260

How we calculate the fair BaseRate →

How this hospital compares to other OR hospitals

Highest price of the 9 OR hospitals we have prices for — worth calling around.

Cheapest $26 Priciest $117

Black dot = this hospital, among the 9 OR hospitals with a price for this procedure. Full list below.

A fair price for a X-ray, pelvis is about $104 (about 1.0× the $107 Medicare rate). Santiam Hospital & Clinics charges insurers about $117, or about $260 in cash — about the fair price. Located in Stayton, OR.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$34 - $402	32%
Blue Cross Blue Shieldmajor	$117 - $1,557	110%
Aetnamajor	$32 - $372	30%
Cignamajor	$35 - $404	33%
Humanamajor	$117	110%
Kaiser Permanentemajor	$13 - $397	12%
Devoted Health	$124	116%
Health Net	$39 - $455	37%
Moda Health	$35 - $407	33%
+ 11 smaller / regional plans	$13 - $455

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 260), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72170.

Insurance Before you use insurance

Call your insurance company to confirm Santiam Hospital & Clinics is in-network.
Ask your insurer whether prior approval is required for CPT code 72170.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Santiam Hospital & Clinics

Compare: X-ray, pelvis at other OR hospitals

Insurance negotiated median for the same procedure, sorted lowest first.