CMS Price Transparency Data
X-ray, pelvis
Facility: St Mary Medical Center
Billing Code: 72170 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72170
- Insurance Median: $10
- Cash Discount Price: $804
- vs. Medicare Baseline: 0.09x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at St Mary Medical Center is $10. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $804. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.09x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$804
Average discount available for prompt cash payment at this facility.
Insurance Median
$10
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: $804 (753%)
Insurance Median: $10 (9%)
Cash: $804 (753% of Medicare)
Ins. Median: $10 (9% 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
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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 | $5 - $18,340 | 5% |
| Community Health Choice | $7 - $8 | 7% |
| Aetna | $8 - $14,649 | 7% |
| Albany County Correctional Facility | $8 | 7% |
| Align Senior Care | $8 - $14,118 | 7% |
| Ally Align Care Adv | $8 | 7% |
| Ambetter / Centene | $8 - $24,706 | 7% |
| American Health Advantage Of Idaho | $8 | 7% |
| American Health Plan | $8 | 7% |
| Amish Mennonite | $8 | 7% |
| Ascension St. Vincent Public Safety Medical | $8 | 7% |
| Aurora Special Needs | $8 | 7% |
| Bcccp-Michigan | $8 | 7% |
| Bccp | $8 | 7% |
| Blue Care Network Advantage | $8 | 7% |
| Blue Cross Blue Shield | $8 - $13,841 | 7% |
| Blue Shield - De (Highmark) Medciare Advantage | $8 | 7% |
| Bmc Healthnet | $8 | 7% |
| Breast Grant-Connecticut | $8 | 7% |
| Broward County Dept Of Health | $8 | 7% |
| California Health And Wellness | $8 | 7% |
| Cardinal Innovations Lme | $8 | 7% |
| Care Connections Of Northern Iowa | $8 | 7% |
| Care Dimensions | $8 | 7% |
| Care Improvement Plus | $8 | 7% |
| Care Oregon Ohp | $8 | 7% |
| Care Resources Pace | $8 | 7% |
| Careplus Health Plans | $8 | 7% |
| Cca - Zing Health | $8 | 7% |
| Cca Senior Care Options | $8 | 7% |
| Cencal Health Plan | $8 | 7% |
| Cenpatico | $8 | 7% |
| Central Valley Medical Services Corp Pace | $8 | 7% |
| Champion Health Plan Mcr Advantage | $8 | 7% |
| Champva | $8 | 7% |
| Chhuny | $8 | 7% |
| Childrens Comm Health Plan | $8 | 7% |
| Childrens Medical Services Title 19 | $8 | 7% |
| Cigna | $8 - $13,971 | 7% |
| City Of Philadelphia | $8 | 7% |
| Clear Spring Health | $8 | 7% |
| Clover Health | $8 | 7% |
| Cmh Allegan County | $8 | 7% |
| Cmh Ausable Valley | $8 | 7% |
| Cmh Barry County | $8 | 7% |
| Cmh Bay-Arenac County | $8 | 7% |
| Cmh Berrien County | $8 | 7% |
| Cmh Cass County | $8 | 7% |
| Cmh Central Mi County | $8 | 7% |
| Cmh Clinton-Eaton-Ingham County | $8 | 7% |
| Cmh Detroit Wayne Integrated Health Network | $8 | 7% |
| Cmh Genesee County | $8 | 7% |
| Cmh Ionia County | $8 | 7% |
| Cmh Jackson County/Lifeways | $8 | 7% |
| Cmh Kalamazoo | $8 | 7% |
| Cmh Kent County | $8 | 7% |
| Cmh Lenawee County | $8 | 7% |
| Cmh Livingston County | $8 | 7% |
| Cmh Macomb | $8 | 7% |
| Cmh Misc | $8 | 7% |
| Cmh Monroe County | $8 | 7% |
| Cmh Montcalm County | $8 | 7% |
| Cmh Muskegon County | $8 | 7% |
| Cmh Newaygo County | $8 | 7% |
| Cmh North Country | $8 | 7% |
| Cmh Northern Lakes County | $8 | 7% |
| Cmh Oakland County | $8 | 7% |
| Cmh Ottawa County | $8 | 7% |
| Cmh Van Buren County | $8 | 7% |
| Cmh Washtenaw County | $8 | 7% |
| Cmh Wayne County/Carelink | $8 | 7% |
| Cmh Wayne Cty/Com Liv Svcs | $8 | 7% |
| Cmh West Mi County | $8 | 7% |
| Commonwealth Care Alliance | $8 | 7% |
| Community Benefit Health | $8 | 7% |
| Community Care Behavorial Health | $8 | 7% |
| Community Care Partners | $8 | 7% |
| Community Pace At Home | $8 | 7% |
| Connections Csp | $8 | 7% |
| County Coroner | $8 | 7% |
| County Funding Generic | $8 | 7% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $8 | 7% |
| Dean Wi Badgercare | $8 | 7% |
| Delaware County Department Of Health | $8 | 7% |
| Delaware First Health | $8 | 7% |
| Delta Dental Nj | $8 | 7% |
| Dph Tb Program | $8 | 7% |
| Dscc | $8 | 7% |
| Eastpointe Lme | $8 | 7% |
| Eddy Senior Care-Pace | $8 | 7% |
| Eddy Seniorcare Pace | $8 | 7% |
| Elementcare | $8 | 7% |
| Everence | $8 | 7% |
| Family Health Network | $8 | 7% |
| Freedom First Healthcare | $8 | 7% |
| Fresno County Ccs | $8 | 7% |
| Gateway Health Plan | $8 | 7% |
| Genesys Pace Of Genesee County | $8 | 7% |
| Georgia Health Advantage | $8 | 7% |
| Ghc Scw Wi Badgercare | $8 | 7% |
| Gold Advantage | $8 | 7% |
| Gpa Croell Redi Mix | $8 | 7% |
| Harbor Health | $8 | 7% |
| Health Safety Net | $8 | 7% |
| Healthy Blue Ne | $8 | 7% |
| Hennepin Health | $8 | 7% |
| Highmark Health Options Dual Plan | $8 | 7% |
| Hope Select Pace | $8 | 7% |
| Horizon Nj Total Care | $8 | 7% |
| Hudson Headwaters Pace | $8 | 7% |
| Humana | $8 - $16 | 7% |
| Huron Valley Pace | $8 | 7% |
| Id County Ada | $8 | 7% |
| Id County Canyon | $8 | 7% |
| Id County Cat Fund | $8 | 7% |
| Id County Other | $8 | 7% |
| Id County Payette | $8 | 7% |
| Idaho Dept Health And Wellfare | $8 | 7% |
| Idaho Womens Health Check | $8 | 7% |
| Indiana Breast Cervical Cancer | $8 | 7% |
| Inland Empire Health Plan | $8 | 7% |
| Innovative Integrated Health Community Plans | $8 | 7% |
| Intercommunity Health Ohp | $8 | 7% |
| Iowa Health Advantage | $8 | 7% |
| Iowa Total Care | $8 | 7% |
| Jai Medical System | $8 | 7% |
| Johns Hopkins Advantage Md | $8 | 7% |
| Kern Family Health Plan | $8 | 7% |
| Keystone First | $8 - $18,340 | 7% |
| Keystone First Chip | $8 - $18,340 | 7% |
| La Care Health Plan | $8 | 7% |
| Lakeland Care Inc | $8 | 7% |
| Lasso Healthcare Msa | $8 | 7% |
| Life St Marys Pace | $8 | 7% |
| Lifecircles Pace | $8 | 7% |
| Longevity Health Plan | $8 | 7% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $8 | 7% |
| Managed Health Services - Indiana | $8 | 7% |
| Martins Point Generations Advantage | $8 | 7% |
| Maryland Breast & Cervical Program | $8 | 7% |
| Maryland Healthy Smiles - Scion Dental | $8 | 7% |
| Maryland Physicians Care | $8 | 7% |
| Mass General Brigham Mcr Adv | $8 | 7% |
| Massachusetts Behavioral Health Partnership | $8 | 7% |
| Mdwise | $8 | 7% |
| Medi-Cal | $8 | 7% |
| Medi-Cal Healthnet | $8 | 7% |
| Medicare (plans) | $8 - $24,913 | 7% |
| Medipak Advantage | $8 | 7% |
| Medstar Dc Healthy Family | $8 | 7% |
| Medstar Md Health Choice | $8 | 7% |
| Mercy Life | $8 | 7% |
| Mercyone Cedar Valley | $8 | 7% |
| Meridian Complete | $8 | 7% |
| Michigan Complete Health | $8 | 7% |
| Mo Home State Health Plan | $8 | 7% |
| Molina Centennial Care | $8 | 7% |
| Nascentia Health Options | $8 | 7% |
| Nascentia Health Plus | $8 | 7% |
| Nebraska Total Care | $8 | 7% |
| New Centry Health Careplus | $8 | 7% |
| New York Cancer Services Program | $8 | 7% |
| Nextlevel Health | $8 | 7% |
| Oregon Screenwise | $8 | 7% |
| Osu Prime Care Advantage | $8 | 7% |
| Pace Cny | $8 | 7% |
| Pace Iowa Immanuel Pathways | $8 | 7% |
| Pace Of Southwest Michigan | $8 | 7% |
| Pace Southeast | $8 | 7% |
| Pace-Trinity Health | $8 - $37 | 7% |
| Paramount Advantage | $8 | 7% |
| Parkland Community Health Plan | $8 | 7% |
| Partners Behavioral Lme | $8 | 7% |
| Peach State Healthplan | $8 | 7% |
| Peak Pace Solutions | $8 | 7% |
| Perennial Advantage | $8 | 7% |
| Philadelphia County Funding | $8 | 7% |
| Preferred Care Partners | $8 | 7% |
| Presbyterian Centennial Care | $8 | 7% |
| Presbyterian Senior Plan | $8 | 7% |
| Prestige Health Choice | $8 | 7% |
| Priority Partners | $8 | 7% |
| Provider Partners Health Plan Of Illinois | $8 | 7% |
| Provider Partners Health Plan Of Indiana | $8 | 7% |
| Pruitthealth Premier | $8 | 7% |
| Reliance Community Care Partners Care Resources Pace | $8 | 7% |
| Robert F Sing Program | $8 | 7% |
| Rx 340B Pass Along | $8 | 7% |
| Rx Allwin | $8 | 7% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $8 | 7% |
| Rx Grane Grnmedd | $8 | 7% |
| Rx Medi-Cal | $8 | 7% |
| Rx Meridian Rx | $8 | 7% |
| Rx Retiree Rx Care | $8 | 7% |
| Ryan White Florida Mssrp | $8 | 7% |
| Sandhills Center Lme | $8 | 7% |
| Scan Health Plan Mcr Ipa Meritage Oon | $8 | 7% |
| Screening For Life | $8 | 7% |
| Secure Horizons Ma Pffs | $8 | 7% |
| Serenity Pace | $8 | 7% |
| Siouxland Pace | $8 | 7% |
| Solis Health Plans | $8 | 7% |
| St Joseph County Hlth Dpt | $8 | 7% |
| Stephenson Cty Health | $8 | 7% |
| Sunnyview-Pace Finance Dept | $8 | 7% |
| Sunshine State Health Plan | $8 | 7% |
| Superior Health | $8 | 7% |
| Tenncare | $8 | 7% |
| Texan Plus | $8 | 7% |
| Texas Children'S Health Plan | $8 | 7% |
| The Health Plan | $8 | 7% |
| Thome Pace | $8 | 7% |
| Todays Options | $8 | 7% |
| Tribute Health Plans | $8 | 7% |
| Tricare | $8 | 7% |
| Trillium Community Ohp | $8 | 7% |
| Triwest Health Alliance | $8 | 7% |
| Tufts Health Public Plans | $8 | 7% |
| Um Health Advantage | $8 | 7% |
| Union Health Service | $8 | 7% |
| UnitedHealthcare | $8 - $163 | 7% |
| Us Family Health Plan | $8 | 7% |
| Vaya Health Lme | $8 | 7% |
| Veterans Eval Services | $8 | 7% |
| Washtenaw Health Plan | $8 | 7% |
| Welbe Health | $8 | 7% |
| Wellmed | $8 | 7% |
| Wellsense Health Plan | $8 | 7% |
| Wi Womens Wellness | $8 | 7% |
| Evercare | $9 | 8% |
| Veterans Administration | $9 | 8% |
| Andrie Inc | $10 | 9% |
| East Greenbush Central School District | $10 | 9% |
| Genex Wc | $10 | 9% |
| Health America Advantra | $10 - $16,609 | 9% |
| Healthsmart Workers Comp | $10 | 9% |
| Jag Source | $10 | 9% |
| New York State Insurance Fund | $10 | 9% |
| Njm Insurance Group | $10 | 9% |
| Rx Heatlhcomp | $10 | 9% |
| Rx Restat | $10 | 9% |
| Rx Saif Opdp Wc | $10 | 9% |
| Rx Worker'S Comp | $10 | 9% |
| Wc Accident Fund | $10 | 9% |
| Wc Ace | $10 | 9% |
| Wc Acs Federal Employees | $10 | 9% |
| Wc Acuity | $10 | 9% |
| Wc Advantage | $10 | 9% |
| Wc Aegis | $10 | 9% |
| Wc Aig | $10 | 9% |
| Wc Aims | $10 | 9% |
| Wc Alaska National Ins | $10 | 9% |
| Wc Align Network | $10 | 9% |
| Wc Allied | $10 | 9% |
| Wc Am Trust N America | $10 | 9% |
| Wc American Claims Mgmt | $10 | 9% |
| Wc Amerisure | $10 | 9% |
| Wc Amtrust | $10 | 9% |
| Wc Asu Risk Mgt | $10 | 9% |
| Wc Benetech | $10 | 9% |
| Wc Berkley Admin | $10 | 9% |
| Wc Broadspire | $10 | 9% |
| Wc Broward County | $10 | 9% |
| Wc Bunch & Associates | $10 | 9% |
| Wc California State Comp Ins | $10 | 9% |
| Wc California State Ins Fund | $10 | 9% |
| Wc Capitol Area Health Consortium | $10 | 9% |
| Wc Ccmsi | $10 | 9% |
| Wc Chartis | $10 | 9% |
| Wc Chubb | $10 | 9% |
| Wc Cirma | $10 | 9% |
| Wc City Of Albany | $10 | 9% |
| Wc City Of Sioux City | $10 | 9% |
| Wc Claims Mgmt Inc | $10 | 9% |
| Wc Cna | $10 | 9% |
| Wc Comp One Admin C/O Manageability | $10 | 9% |
| Wc Compone Admin | $10 | 9% |
| Wc Corvel | $10 | 9% |
| Wc Ct Healthcare Trust | $10 | 9% |
| Wc Donegal Insurance Group | $10 | 9% |
| Wc Emc Insurance Company | $10 | 9% |
| Wc Employee Mutual | $10 | 9% |
| Wc Enablecomp | $10 | 9% |
| Wc Encore Health Network | $10 | 9% |
| Wc Erie | $10 | 9% |
| Wc Esis | $10 | 9% |
| Wc Evolutions | $10 | 9% |
| Wc Fcci | $10 | 9% |
| Wc Fed Ex | $10 | 9% |
| Wc Federal Black Lung | $10 | 9% |
| Wc Federated | $10 | 9% |
| Wc Finley Occupational Health | $10 | 9% |
| Wc First Agency/Occunet | $10 | 9% |
| Wc Ford Motor | $10 | 9% |
| Wc Fresno Unified Emp | $10 | 9% |
| Wc Gallagher Bassett | $10 | 9% |
| Wc General Motors | $10 | 9% |
| Wc Generic | $10 | 9% |
| Wc Genex Care For Ohio | $10 | 9% |
| Wc Great West Casualty | $10 | 9% |
| Wc Guarantee Insurance | $10 | 9% |
| Wc Guard Insurance Company | $10 | 9% |
| Wc Hab | $10 | 9% |
| Wc Hartford | $10 | 9% |
| Wc Hastings | $10 | 9% |
| Wc Health Management | $10 | 9% |
| Wc Heritage Summit | $10 | 9% |
| Wc Hireright | $10 | 9% |
| Wc Horizon | $10 | 9% |
| Wc Icw Group | $10 | 9% |
| Wc Idaho State Ins Fund | $10 | 9% |
| Wc Intercare Insurance | $10 | 9% |
| Wc Intermountain | $10 | 9% |
| Wc Johns Eastern | $10 | 9% |
| Wc Kemberton | $10 | 9% |
| Wc Key Ins & Benefit Solutions | $10 | 9% |
| Wc Liberty Mutual | $10 | 9% |
| Wc Mac Risk Management | $10 | 9% |
| Wc Massachusetts | $10 | 9% |
| Wc Mdia | $10 | 9% |
| Wc Meadowbrook Claim | $10 | 9% |
| Wc Medical Administrators | $10 | 9% |
| Wc Meijers | $10 | 9% |
| Wc Memic | $10 | 9% |
| Wc Mercy Workcare | $10 | 9% |
| Wc Michigan | $10 | 9% |
| Wc Michigan Millers Mutual | $10 | 9% |
| Wc Mitchell Frankenmuth | $10 | 9% |
| Wc Mra | $10 | 9% |
| Wc Nationwide | $10 | 9% |
| Wc Nca Comp | $10 | 9% |
| Wc New York | $10 | 9% |
| Wc New York Special Funds | $10 | 9% |
| Wc North American Rishces | $10 | 9% |
| Wc Northeast Health | $10 | 9% |
| Wc Notre Dame | $10 | 9% |
| Wc Novanet | $10 | 9% |
| Wc O'Hara Corp | $10 | 9% |
| Wc Occ Health Allen | $10 | 9% |
| Wc Ohio Bureau | $10 | 9% |
| Wc One Call Medical | $10 | 9% |
| Wc Paradigm | $10 | 9% |
| Wc Peerless | $10 | 9% |
| Wc Pma | $10 | 9% |
| Wc Praxis Health Network | $10 | 9% |
| Wc Price Chopper | $10 | 9% |
| Wc Procura Management | $10 | 9% |
| Wc Qualcare | $10 | 9% |
| Wc Quiktrip | $10 | 9% |
| Wc Reny Company | $10 | 9% |
| Wc Rev Claims | $10 | 9% |
| Wc Risico | $10 | 9% |
| Wc Rural Mutual | $10 | 9% |
| Wc Saif Oregon | $10 | 9% |
| Wc Secura | $10 | 9% |
| Wc Sedgwick | $10 | 9% |
| Wc Sentry | $10 | 9% |
| Wc Sheakley Unicomp | $10 | 9% |
| Wc Smile Lodge | $10 | 9% |
| Wc Society | $10 | 9% |
| Wc Srs | $10 | 9% |
| Wc Taconic (Mro) | $10 | 9% |
| Wc Taconic Farms | $10 | 9% |
| Wc Travelers | $10 | 9% |
| Wc Triad Group | $10 | 9% |
| Wc Tristar | $10 | 9% |
| Wc Troy Ny | $10 | 9% |
| Wc Tyson | $10 | 9% |
| Wc Unified Health Services | $10 | 9% |
| Wc United Heartland | $10 | 9% |
| Wc Us Dept Of Labor | $10 | 9% |
| Wc Velocity | $10 | 9% |
| Wc Walmart | $10 | 9% |
| Wc West Bend | $10 | 9% |
| Wc West Bend Mutual/Argent | $10 | 9% |
| Wc Winnebago Industries | $10 | 9% |
| Wc Yankee Trails | $10 | 9% |
| Wc York Risk | $10 | 9% |
| Wc Zenith | $10 | 9% |
| Wc Zurich | $10 | 9% |
| Amerihealth | $11 - $4,829 | 10% |
| Bcn Domestic | $11 | 10% |
| Blue Benefit Administrators Of Massachusetts | $11 | 10% |
| Blue Care Network | $11 | 10% |
| Blue Distinction Transplant | $11 | 10% |
| Blue Shield - Ca | $11 - $4,829 | 10% |
| Blue Shield - Id (Regence) | $11 - $4,829 | 10% |
| Blue Shield - Ny Highmark Northeastern | $11 | 10% |
| Blue Shield - Ny Highmark Western | $11 - $4,829 | 10% |
| Blue Shield - Pa (Highmark) | $11 - $37,426 | 10% |
| Blue Shield - Wa (Regence) | $11 - $4,829 | 10% |
| Geha | $11 - $138 | 10% |
| Health Choices | $11 | 10% |
| Health Partners | $11 | 10% |
| Jefferson Health Plan Commercial | $11 - $25,190 | 10% |
| Kaiser Domestic | $11 | 10% |
| Pre-Employment | $11 | 10% |
| Prime Healthcare | $11 - $24,913 | 10% |
| Wc Domestic | $11 | 10% |
| Oscar | $13 - $24,913 | 12% |
| Devon Health Services | $16 | 15% |
| First Health | $16 | 15% |
| Homestead Health Plans Woods Center | $17 - $26,990 | 16% |
| Prime Health Services | $17 - $303 | 16% |
| Three Rivers Provider Network | $17 - $320 | 16% |
| Coventry | $18 | 17% |
| Group Pension Administrators | $18 - $31,142 | 17% |
| Health America | $18 | 17% |
| Meritain | $18 - $300 | 17% |
| Multiplan | $18 - $303 | 17% |
| Reedman Toll | $18 - $31,142 | 17% |
| Upmc Health Plan | $69 - $7,033 | 65% |
| Webtpa | $69 - $7,033 | 65% |
| Galaxy Health Network | $320 | 300% |