CMS Price Transparency Data

X-ray, pelvis

Facility: Medical City North Hills

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $129
Cash Discount Price: $884
vs. Medicare Baseline: 1.21x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Medical City North Hills is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $884. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.21x the Medicare baseline. Located in 4401 Booth Calloway Road, North Richland Hills, TX.

Cash / Self-Pay

$884

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $884 (828%)

Insurance Median: $129 (121%)

Cash: $884 (828% of Medicare)

Ins. Median: $129 (121% 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
Amerigroup	$28	26%
Cook Childrens Health Plan	$28	26%
Parkland Community Health Plan	$28	26%
United	$28 - $245	26%
Cigna	$29 - $707	27%
Aetna	$30 - $643	28%
Molina	$31	29%
Humana	$35 - $92	33%
Superior Health Plan	$62	58%
Blue Cross Blue Shield	$133 - $479	125%
Unicare	$186 - $884	174%
Healthcare Highways	$217 - $299	203%
Evry Health	$228	213%
Curative Administrators	$354	331%
City Of Mckinney	$398	373%
Fidelis Securecare	$398	373%
National Choicecare	$442	414%
Pc Texas Partners	$486	455%
Physicians Coop Of Tx	$486	455%
Rockport Health Group	$486	455%
Averde Health, Inc	$513	480%
Magellan Behavior Health	$530	496%
Coastal Comp Health Networks	$619	580%
Mega Life	$619	580%
Multiplan Phcs	$619	580%
Healthsmart Preferred Care	$663	621%
Lewisville Isd/Dls Consulting	$663	621%
Usa Managed Care	$707	662%
Usc Health Services	$707	662%
Galaxy Health Network	$751	703%
Independent Medical Systems	$884	828%
National Healthcare Solutions	$884	828%

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 $884.
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 Medical City North Hills 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.