CMS Price Transparency Data

X-ray, pelvis

Facility: Sweeny Community Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $170
Cash Discount Price: $158
vs. Medicare Baseline: 1.59x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Sweeny Community Hospital is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.59x the Medicare baseline. Located in 305 North McKinney, Sweeny, TX.

Cash / Self-Pay

$158

Average discount available for prompt cash payment at this facility.

Insurance Median

$170

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: $158 (148%)

Insurance Median: $170 (159%)

Cash: $158 (148% of Medicare)

Ins. Median: $170 (159% 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	$79 - $131	74%
Evercare Mcaid	$131	123%
UnitedHealthcare	$142 - $210	133%
Aetna	$152 - $210	142%
Amerigroup Mcr Adv - All Other Plans	$152	142%
Community Hlth Choice Him - All Other Plans	$152	142%
Coventry Mcr Adv	$152	142%
Molina Mcr Adv - All Other Plans	$152	142%
Superior Hp Mcr Adv-All Other Plans	$152	142%
Wellcare Mcare - All Plans	$152	142%
Care Improvement Mcr - All Plans	$154	144%
Choicecare Mcr Adv - All Plans	$154	144%
Community Hlth Choice Star	$185	173%
Molina Mcaid	$185	173%
Superior Hp Mcaid	$185	173%
Tx Chlidrens Hp Mcaid - All Plans	$185	173%
Tx True Choice Mcaid - All Plans	$185	173%
Beech Street - All Plans	$197	184%
Community Care Network - All Plans	$210	197%
Galaxy Health Network - All Plans	$236	221%
Multiplan - All Plans	$236	221%
Evercare Mcr Adv - All Other Plans	$255	239%
Amerigroup Mcaid	$263	246%

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 $158.
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 Sweeny Community Hospital 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.