CMS Price Transparency Data

X-ray, pelvis

Facility: Cook Childrens Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $214
Cash Discount Price: $434
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Cook Childrens Medical Center is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $434. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.00x the Medicare baseline. Located in 801 Seventh Avenue, Fort Worth, TX.

Cash / Self-Pay

$434

Average discount available for prompt cash payment at this facility.

Insurance Median

$214

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: $434 (406%)

Insurance Median: $214 (200%)

Cash: $434 (406% of Medicare)

Ins. Median: $214 (200% 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 200% of the Medicare baseline (a markup of 100%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Beacon	$23 - $165	22%
Firstcare	$23 - $550	22%
Health Plan W/O Uhrip	$23 - $165	22%
Rightcare	$32 - $230	30%
Molina	$35 - $254	33%
Health Plan W. Uhrip	$36 - $261	34%
El Paso Health First	$42 - $302	39%
Tx Children Health	$42 - $302	39%
Aetna	$48 - $343	45%
UnitedHealthcare	$56 - $584	52%
Blue Cross Blue Shield	$73 - $577	68%
S&W Health	$80 - $577	75%
Cigna	$81 - $584	76%
Healthscope	$81 - $584	76%
Imagine Health	$81 - $584	76%
Humana	$83 - $605	78%
Multiplan	$83 - $598	78%
First Health	$84 - $605	79%
Galaxy Health	$86 - $618	81%
Usamco	$88 - $632	82%

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 $434.
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 Cook Childrens Medical Center 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.