CMS Price Transparency Data

X-ray, pelvis

Facility: Samaritan Lebanon Community Hospital

Billing Code: 72170 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$28
about 0.3× the $107 Medicare rate · typically $22–$63
modeled estimate · not a bill or quote
What this hospital charges insurers
$26
About the fair price
about $2 under the fair price · 0.2× Medicare
Medicare pays $107 Fair price $28 This hospital $26 Cash price $59 Hospital's list price $74

How we calculate the fair BaseRate →

How this hospital compares to other OR hospitals

Lowest price of the 9 OR hospitals we have prices for — a strong deal.

Cheapest $26 Priciest $45

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 $28 (about 0.3× the $107 Medicare rate). Samaritan Lebanon Community Hospital charges insurers about $26, or about $59 in cash — about the fair price. Located in Lebanon, OR.

What each insurance company pays

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

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

✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana UnitedHealthcareKaiser 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
Blue Cross Blue Shieldmajor $9 - $476 8%
Aetnamajor $14 - $504 13%
Cignamajor $8 - $514 7%
Humanamajor $8 - $31 7%
Devoted Health $8 - $177 7%
Health Net $8 - $514 7%
Moda Health $10 - $69 9%
PacificSource $7 - $172 7%
+ 4 smaller / regional plans $8 - $514

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

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

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 525 N Santiam Highway, Lebanon, OR 97355
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals