CMS Price Transparency Data

X-ray, pelvis

Facility: Pennsylvania Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $257
  • Cash Discount Price: $643
  • vs. Medicare Baseline: 2.41x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Pennsylvania Hospital is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $643. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.41x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$643

Average discount available for prompt cash payment at this facility.

Insurance Median
$257

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: $643 (602%)
Insurance Median: $257 (241%)
Cash: $643 (602% of Medicare)
Ins. Median: $257 (241% 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 241% of the Medicare baseline (a markup of 141%). 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
Gateway Health Plan $10 - $136 9%
Medicaid / KanCare $10 - $643 9%
Keystone Mercy Health Plan $13 12%
Upmc $15 - $643 14%
Pa Medical Assistance $18 17%
UnitedHealthcare $20 - $643 19%
Health Partners $27 - $643 25%
Blue Cross Blue Shield $28 - $643 26%
Keystone Hmo Proactive $30 28%
Ibc Commercial Hpn $31 29%
Cigna $52 - $113 49%
Aetna $92 - $643 86%
Horizon Nj Health $109 - $113 102%
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 - $514 106%
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%
Pgm - Regie De L'Assurance Maladie Quebec $148 139%
Elap $155 145%
Preferred Health Care Eliance $167 156%
Claims Watcher $175 - $197 164%
Oscar Health Plan $186 174%
Centivo $197 184%
Elap Services $203 190%
Pgm - Kuwait Defense $225 - $289 211%
Highmark $230 215%
Devon $244 - $289 228%
Qualcare $244 228%
Coventry $257 - $328 241%
Pgm - Chop $257 241%
Wissahickon Hospice $257 241%
Healthamerica/Coventry $289 - $315 271%
Penn Global Medicine $290 272%
Olympus $312 292%
First Health Global $322 301%
Urn-Cancer Resource Services $322 301%
Health Net $386 361%
Pgm - Royal Embassy Of Saudi Arabia $386 361%
Pgm - Embassy Of Qatar $418 391%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $418 391%
Pgm - Embassy Of The United Emirates/Ipc $450 421%
Devon Health Services Inc $514 481%
Health America/Ccn $514 481%
Intergroup $514 481%
Pgm - Kuwait Health Division $514 481%
Pgm - Kuwait Oil $514 481%
Preferred Care $514 481%
Commercial Other $643 602%
Community Behavioral Health $643 602%
International Pfs $643 602%
Quest Behavioral Health $643 602%
United Behavioral Health $643 602%
Workers Compensation $643 602%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals