CMS Price Transparency Data

X-ray, pelvis

Facility: Blount Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $150
Cash Discount Price: $113
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Blount Memorial Hospital is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.40x the Medicare baseline. Located in 907 E Lamar Alexander Parkway, Maryville, TN.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$150

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: $113 (106%)

Insurance Median: $150 (140%)

Cash: $113 (106% of Medicare)

Ins. Median: $150 (140% 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
Medicaid / KanCare	$20 - $86	19%
UnitedHealthcare	$21 - $252	20%
Blue Cross Blue Shield	$69 - $102	65%
Prisma Health Seniorcare Pace - Midlands [5400]	$84	79%
Prisma Health Seniorcare Pace-Upstate [5200]	$84	79%
Humana	$98	92%
Medicare (plans)	$98 - $102	92%
Tricare	$99	93%
Cigna	$102 - $182	95%
Bob Jones Univ-Pai [821]	$112	105%
Promise Health Plan Contracted [2401]	$127 - $218	119%
Orangeburg Senior Helping Center Pace [5401]	$146	137%
Mvp Health Care [3037]	$150	140%
Ambetter / Centene	$154	144%
Consociate Health Contracted [4835]	$218	204%
Fairos/Occunet Contracted [4837]	$228	213%
Golden Rule Insurance Company [2991]	$252	236%
Oxford Health Plans [2992]	$252	236%
Preferred Administrators Contracted [2839]	$255	239%
Medcost [2940]	$269 - $302	252%
Atlantic Packaging Contracted [4833]	$273	256%
Aps Healthcare System [2981]	$291	272%
Multiplan/Phcs Contracted [2950]	$324	303%
Aetna	$328	307%
Meritain Health Contracted [2200]	$328	307%
Nippon [2300]	$328	307%
Vsp Vision Care [2986]	$328	307%
First Health Contracted [2952]	$339	317%
Furman Int/Allen University Student [2951]	$339	317%
Quiktrip-First Health [3067]	$339	317%

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 $113.
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 Blount Memorial Hospital 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.