CMS Price Transparency Data

X-ray, pelvis

Facility: Lehigh Valley Hospital - Dickson City

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $107
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Lehigh Valley Hospital - Dickson City is $107. 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 1.00x the Medicare baseline. Located in 330 Main Street, Dickson City, PA.

Cash / Self-Pay

Unavailable

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%)

Insurance Median: $107 (100%)

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.

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
Amerihealth Caritas	$19 - $34	18%
Geisinger	$19 - $232	18%
UnitedHealthcare	$20 - $411	19%
Highmark Wholecare/Gateway	$22 - $39	21%
Aetna	$23 - $567	22%
Jefferson Health Partners	$24 - $107	22%
Pa Health & Wellness	$24 - $41	22%
Upmc	$29 - $498	27%
Cigna	$87	81%
Highmark Blue Shield	$104 - $435	97%
Amerihealth	$105	98%
Devoted Health	$108	101%
Humana	$108	101%
Emblem	$110 - $456	103%
Pa Health & Wellness (Allwell)	$113	106%
Gateway	$114	107%
Ambetter / Centene	$310	290%
Valley Preferred	$597	559%

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 Lehigh Valley Hospital - Dickson City 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.