CMS Price Transparency Data

X-ray, pelvis

Facility: Prisma Health Tuomey Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $103
  • Cash Discount Price: $255
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Prisma Health Tuomey Hospital is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $255. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.96x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$255

Average discount available for prompt cash payment at this facility.

Insurance Median
$103

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: $255 (239%)
Insurance Median: $103 (96%)
Cash: $255 (239% of Medicare)
Ins. Median: $103 (96% 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
Medicaid / KanCare $34 - $61 32%
Humana $36 - $295 34%
Blue Cross Blue Shield $59 - $266 55%
Bluechoice [810] $59 - $265 55%
Scdc-Sc Dept Of Corrections [7232] $59 55%
UnitedHealthcare $61 - $240 57%
Prisma Health Seniorcare Pace - Midlands [5400] $91 85%
Prisma Health Seniorcare Pace-Upstate [5200] $91 85%
Cigna $98 - $393 92%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $98 92%
Medicare (plans) $98 - $103 92%
Triwest Healthcare Alliance Vcp [902] $98 92%
Va Community Care Network-Vaccn [903] $98 92%
Tricare $100 94%
Aetna $103 - $310 96%
Healthy Conn Prime-First Choice Vip Care [5300] $103 96%
Healthy Conn Prime-Molina Healthcare [5330] $103 96%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $103 96%
Bob Jones Univ-Pai [821] $112 105%
Workers Comp [600] $137 128%
Promise Health Plan Contracted [2401] $138 - $236 129%
Orangeburg Senior Helping Center Pace [5401] $157 147%
Ambetter / Centene $180 169%
Golden Rule Insurance Company [2991] $240 225%
Oxford Health Plans [2992] $240 225%
Zzumr-Salt Lake City Ut [3169] $240 225%
Meritain Health Contracted [2200] $252 - $310 236%
Planned Administrators [820] $266 249%
Preferred Administrators Contracted [2839] $275 257%
Medcost [2940] $291 - $326 272%
Atlantic Packaging Contracted [4833] $295 276%
Aps Healthcare System [2981] $314 294%
Multiplan/Phcs Contracted [2950] $350 328%
Vsp Vision Care [2986] $354 331%
First Health Contracted [2952] $365 342%
Furman Int/Allen University Student [2951] $365 342%
Quiktrip-First Health [3067] $365 342%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals