CMS Price Transparency Data

X-ray, pelvis

Facility: Ascension Providence

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $104
Cash Discount Price: $123
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Ascension Providence is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.97x the Medicare baseline. Located in 6901 Medical Parkway, Waco, TX.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $123 (115%)

Insurance Median: $104 (97%)

Cash: $123 (115% of Medicare)

Ins. Median: $104 (97% 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	$28 - $275	26%
Medicaid / KanCare	$28 - $30	26%
Superior Chip/Chip Perinate	$28 - $30	26%
Superior Star	$28 - $30	26%
Superior Star Plus	$28 - $30	26%
Swhp Rightcare Star	$28 - $30	26%
UnitedHealthcare	$28 - $106	26%
Wellpoint Star	$28 - $30	26%
Mclennan County Indigent	$30	28%
Firstcare Focus Network	$42	39%
Firstcare Hmo	$47	44%
Medicare (plans)	$104 - $107	97%
Tricare	$104	97%
Va	$104	97%
Aetna	$106	99%
Smarthealth	$146	137%
Ambetter / Centene	$156	146%
Green Imaging	$156	146%
Cigna	$195	183%

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 $123.
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 Ascension Providence 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.