CMS Price Transparency Data

X-ray, pelvis

Facility: Memorial Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $112
  • Cash Discount Price: $152
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Memorial Medical Center is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.05x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$152

Average discount available for prompt cash payment at this facility.

Insurance Median
$112

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: $152 (142%)
Insurance Median: $112 (105%)
Cash: $152 (142% of Medicare)
Ins. Median: $112 (105% 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.

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 Mcr Adv-All Other Plans $8 - $114 7%
Care Improvement Plus - All Other Plans $8 - $114 7%
Care Improvement Plus Mcr $8 - $115 7%
Superior Allwell Mcr Adv-All Other Plans $8 - $114 7%
Triwest Va Pccc-All Plans $8 - $112 7%
UnitedHealthcare $8 - $326 7%
Universal American Mcr-All Other Plans $8 - $114 7%
Ambetter / Centene $9 - $137 8%
Universal American Snp $9 - $120 8%
Coventry First Hlth Hmo Ppo-All Other Plans $10 - $326 9%
Coventry First Hlth Mcr Adv $10 - $114 9%
Capstar Health Network-All Plans $12 - $326 11%
Cigna $12 - $306 11%
Galaxy Health Network-All Plans $12 - $347 11%
Healthcare Highways-All Plans $18 - $326 17%
Prime Healthcare Services-All Plans $19 - $286 18%
Blue Cross Blue Shield $21 - $247 20%
Humana $22 - $326 21%
Corvel Work Comp-All Plans $23 - $347 22%
Independent Med Sys Ppo-All Plans $23 - $347 22%
Multiplan Mcr Adv $23 - $114 22%
Multiplan Phcs Ppo-All Other Plans $23 - $347 22%
Provider Select Ppo-All Plans $23 - $347 22%
Three Rivers Ppo-All Plans $23 - $347 22%
Usa Mso - All Plans $23 - $347 22%
Amerigroup Chip $28 - $196 26%
Amerigroup Star $28 - $196 26%
Amerigroup Star Kids $28 - $196 26%
Amerigroup Star Plus $28 - $196 26%
Comm Health Chip $28 - $196 26%
Comm Health Perinatal-All Other Plans $28 - $196 26%
Molina Chip/Star-All Plans $28 - $196 26%
Scott & White Chip/Star-All Plans $28 - $196 26%
Superior Chip/Star $28 - $196 26%
Texas Childrens Hp - All Plans $28 - $196 26%
Comm Health Mcaid Hmo $29 - $206 27%
Comm Health Star $29 - $206 27%
Aetna $326 305%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals