CMS Price Transparency Data

X-ray, pelvis

Facility: Texas Orthopedic Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $245
  • Cash Discount Price: $1,408
  • vs. Medicare Baseline: 2.29x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Texas Orthopedic Hospital is $245. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,408. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.29x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$1,408

Average discount available for prompt cash payment at this facility.

Insurance Median
$245

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: $1,408 (1318%)
Insurance Median: $245 (229%)
Cash: $1,408 (1318% of Medicare)
Ins. Median: $245 (229% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 229% of the Medicare baseline (a markup of 129%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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%
Community Health Choice Mcd $28 26%
Texas Childrens Health Plans $28 - $234 26%
Texas Health Network $28 26%
United $29 - $634 27%
Aetna $30 - $123 28%
Molina Healthcare $31 29%
Humana $35 - $403 33%
Cigna $71 - $92 66%
Superior Health Plan $84 79%
Blue Cross Blue Shield $197 - $493 184%
Texas Workforce Commission $338 316%
Healthcare Highways $359 336%
Evry Health $384 360%
Imagine Health $493 462%
Christus (Usfhp) $563 527%
Curative Administrators $563 527%
Healthsmart Preferred Care $605 - $1,197 566%
Averde Health $634 594%
Fidelis Securecare Of Tx $634 594%
Coventry National First Health $750 702%
Physicians Cooperative Of Texas $774 725%
Rockport Workers Comp $774 725%
Independent Medical System $845 791%
National Healthcare Solutions $845 791%
Southwest Medical $845 791%
Coastal Comp $915 857%
Multiplan $1,056 - $1,197 989%
International Health Insurance $1,126 1054%
Physicians, Inc $1,197 1121%
Affiliated Ppo $1,267 1186%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals