CMS Price Transparency Data

X-ray, pelvis

Facility: Penn Presbyterian Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $269
  • Cash Discount Price: $672
  • vs. Medicare Baseline: 2.52x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Penn Presbyterian Medical Center is $269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $672. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.52x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$672

Average discount available for prompt cash payment at this facility.

Insurance Median
$269

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: $672 (629%)
Insurance Median: $269 (252%)
Cash: $672 (629% of Medicare)
Ins. Median: $269 (252% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 252% of the Medicare baseline (a markup of 152%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $10 - $672 9%
Keystone Mercy Health Plan $13 - $672 12%
Upmc $15 - $672 14%
Pa Medical Assistance $18 17%
UnitedHealthcare $20 - $672 19%
Health Partners $27 - $672 25%
Blue Cross Blue Shield $28 - $672 26%
Keystone Hmo Proactive $30 28%
Ibc Commercial Hpn $31 29%
Cigna $52 - $113 49%
Aetna $94 - $672 88%
Medicare (plans) $109 - $112 102%
Philadelphia Va Medical Center $109 102%
Tricare $110 103%
Ibc $112 105%
Geisinger Health Plan $113 - $347 106%
Humana $113 - $538 106%
Horizon Nj Health $114 - $118 107%
Pa Health And Wellness $115 - $180 108%
Penn Life (Living Independently For Elders) $115 108%
Clover Health Plan $118 110%
Keystone First $121 113%
Us Family Health Plan $126 118%
Gateway Health Plan $136 127%
Elap $155 145%
Pgm - Regie De L'Assurance Maladie Quebec $155 145%
Preferred Health Care Eliance $168 157%
Claims Watcher $175 - $197 164%
Oscar Health Plan $186 174%
Centivo $197 184%
Elap Services $203 190%
Highmark $230 215%
Pgm - Kuwait Defense $235 - $302 220%
Devon $255 - $302 239%
Qualcare $255 239%
Coventry $269 - $343 252%
Pgm - Chop $269 252%
Wissahickon Hospice $269 252%
Penn Global Medicine $290 272%
Healthamerica/Coventry $302 - $329 283%
Olympus $319 299%
First Health Global $336 315%
Urn-Cancer Resource Services $336 315%
Health Net $403 377%
Pgm - Royal Embassy Of Saudi Arabia $403 377%
Pgm - Embassy Of Qatar $437 409%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $437 409%
Pgm - Embassy Of The United Emirates/Ipc $470 440%
Devon Health Services Inc $538 504%
Health America/Ccn $538 504%
Intergroup $538 504%
Pgm - Kuwait Health Division $538 504%
Pgm - Kuwait Oil $538 504%
Preferred Care $538 504%
Commercial Other $672 629%
International Pfs $672 629%
Magellan $672 629%
Quest Behavioral Health $672 629%
United Behavioral Health $672 629%
Workers Compensation $672 629%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals