CMS Price Transparency Data

X-ray, pelvis

Facility: Temple Health - Chestnut Hill Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $111
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Temple Health - Chestnut Hill Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.04x the Medicare baseline. Located in 8835 Germantown Avenue, Philadelphia, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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%)

Insurance Median: $111 (104%)

Ins. Median: $111 (104% 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.

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
UnitedHealthcare	$14 - $1,252	13%
Geisinger	$21 - $286	20%
Health Partners Plans	$22 - $113	21%
Pennsylvania Health And Wellness	$22 - $199	21%
Upmc Health Plan	$24 - $113	22%
Cigna	$28 - $112	26%
Blue Cross Blue Shield	$47 - $342	44%
Point Comfort	$107	100%
Innovage	$110	103%
Keystone First	$110 - $270	103%
Vibra	$110	103%
Humana	$111	104%
Gateway Health Plan	$113	106%
Aetna	$116 - $794	109%
Sunrise	$118	110%
Elder Health	$129	121%
Naphcare	$161	151%
Occunet	$177	166%
Devon Health	$855	800%

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 $X.
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 Temple Health - Chestnut Hill Hospital 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.