CMS Price Transparency Data

X-ray, pelvis

Facility: Tristar Ashland City Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $155
Cash Discount Price: $1,067
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Tristar Ashland City Medical Center is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,067. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.45x the Medicare baseline. Located in 313 North Main St, Ashland City, TN.

Cash / Self-Pay

$1,067

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $1,067 (999%)

Insurance Median: $155 (145%)

Cash: $1,067 (999% of Medicare)

Ins. Median: $155 (145% 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
Blue Cross Blue Shield	$14 - $2,000	13%
Humana	$33 - $267	31%
Aetna	$37 - $534	35%
Cigna	$63 - $333	59%
United	$155 - $480	145%
Kentucky Labor Cabinet	$196	184%
Apex Health	$203	190%
Nhc Advantage, Inc.	$203	190%
Pruitt Health (Allyalign)	$203	190%
Amerigroup	$331	310%
Bgfh Singlesource	$534 - $907	500%
Multiplan	$587	550%
Southern Health Partners	$640	599%
Employers Health Network	$747	699%
Odom'S Tn Pride Sausage	$800	749%
Beech Street	$982	919%

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 $1,067.
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 Tristar Ashland City Medical Center 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.