CMS Price Transparency Data

X-ray, pelvis

Facility: Children's Hospital of Philadelphia

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $406
Cash Discount Price: $967
vs. Medicare Baseline: 3.80x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Children's Hospital of Philadelphia is $406. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $967. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.80x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$967

Average discount available for prompt cash payment at this facility.

Insurance Median

$406

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: $967 (905%)

Insurance Median: $406 (380%)

Cash: $967 (905% of Medicare)

Ins. Median: $406 (380% 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 380% of the Medicare baseline (a markup of 280%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Geisinger Medical Assistance	$14	13%
Highmark Wholecare	$15	14%
Horizon Nj Health	$60	56%
Medicaid / KanCare	$160	150%
UnitedHealthcare	$160 - $532	150%
Health Partners	$182	170%
Aetna	$254 - $483	238%
Upmc Medical Assistance	$264	247%
Keystone First Chip	$300	281%
Keystone Health Plan East	$306	286%
Blue Cross Blue Shield	$341 - $387	319%
Geisinger Health Plan Commercial	$425	398%
Jefferson Health Plans	$457	428%
Cigna	$483	452%
Highmark	$483	452%
Qualcare	$532	498%
First Health Network	$628	588%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$773	724%
Private Health Care Systems	$773	724%
Choice Care Network	$870	815%

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 $967.
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 Children's Hospital of Philadelphia 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.