CMS Price Transparency Data

X-ray, pelvis

Facility: HCA Houston Healthcare Tomball

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $163
Cash Discount Price: $1,939
vs. Medicare Baseline: 1.53x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at HCA Houston Healthcare Tomball is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,939. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.53x the Medicare baseline. Located in 605 Holderrieth, Tomball, TX.

Cash / Self-Pay

$1,939

Average discount available for prompt cash payment at this facility.

Insurance Median

$163

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: $1,939 (1815%)

Insurance Median: $163 (153%)

Cash: $1,939 (1815% of Medicare)

Ins. Median: $163 (153% 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
Community Health Choice Mcd	$28	26%
Texas Childrens Healthplans	$28	26%
United	$29 - $872	27%
Aetna	$30 - $207	28%
Molina Healthcare	$31	29%
Humana	$35 - $403	33%
Cigna	$71 - $92	66%
Superior Health Plan	$116	109%
Blue Cross Blue Shield	$197 - $679	184%
Healthcare Highways	$494	463%
Evry Health	$529	495%
Coventry National First Health	$706	661%
Christus (Usfhp)	$776	727%
Curative Administrators	$776	727%

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 $1,939.
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 HCA Houston Healthcare Tomball 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.