CMS Price Transparency Data

X-ray, pelvis

Facility: Bella Vista Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $14
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 0.13x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Bella Vista Hospital is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.13x the Medicare baseline. Located in Carr 349 Km 2 7 Cerro Las Mesas, Mayaguez, PR.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$14

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: $50 (47%)
Insurance Median: $14 (13%)
Cash: $50 (47% of Medicare)
Ins. Median: $14 (13% 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.

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
International Medical Card $4 4%
Acaa $5 5%
Asociacion Maestros (Prossam) $7 7%
Servicios De Salud Bella Vista $8 7%
Triple S Vital $11 10%
Mapfre Life Insurance Life Insurance $12 11%
Mcs $12 11%
Medicare (plans) $12 - $86 11%
First Medical Vital $14 13%
Triple S $14 13%
Plan Salud Menonita Vital $16 15%
Fondo Del Seguro Del Estado $18 17%
Champva $20 19%
Tricare $20 19%
Triple S Advantage $20 19%
UnitedHealthcare $20 19%
Plan Salud Menonita $27 25%
Preferred Medical Choice(Pmc) $86 81%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Carr 349 Km 2 7 Cerro Las Mesas, Mayaguez, PR 00681
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals