CMS Price Transparency Data

X-ray, pelvis

Facility: Clarion Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $107
  • Cash Discount Price: $134
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Clarion Hospital is $107. 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 1.00x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$134

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $107 (100%)
Cash: $134 (125% of Medicare)
Ins. Median: $107 (100% 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
Upmc $12 - $120 11%
Medicaid / KanCare $18 17%
Amerihealth $19 - $102 18%
Jefferson Health Plan $19 18%
Geisinger $21 - $107 20%
Workers Comp $68 64%
Highmark $82 - $170 77%
Highmark - Ind.& Managed Care $82 - $230 77%
Martin'S Point - Usfhp $84 - $102 79%
Gateway $89 - $109 83%
Devoted Health Plan $96 - $108 90%
Cigna $102 - $120 95%
Highmark Community Blue $102 95%
Medicare (plans) $102 95%
Tricare $102 95%
UnitedHealthcare $102 95%
Aetna $105 - $235 98%
The Health Plan $108 - $240 101%
Pa Health & Wellness $109 102%
American Health Plan $113 106%
Peak Health $168 - $240 157%
Devon $180 169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals