CMS Price Transparency Data

X-ray, pelvis

Facility: Faith Community Hospital

Billing Code: 72170 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$118

about 1.1× the $107 Medicare rate · typically $49–$211

modeled estimate · not a bill or quote

What this hospital charges insurers

$66

Below the fair price — a good deal

about $52 under the fair price · 0.6× Medicare

Medicare pays $107 Fair price $118 This hospital $66 Cash price $151 Hospital's list price $216

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $20 Priciest $66

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

A fair price for a X-ray, pelvis is about $118 (about 1.1× the $107 Medicare rate). Faith Community Hospital charges insurers about $66, or about $151 in cash — below the fair price — a good deal. Located in Jacksboro, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Humana Blue Cross Blue ShieldAetnaCignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$113	106%
Humanamajor	$19	18%

Government programs also on file: Medicare, Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 151), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72170.

Insurance Before you use insurance

Call your insurance company to confirm Faith Community Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 72170.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Faith Community Hospital

Compare: X-ray, pelvis at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.