CMS Price Transparency Data

X-ray, pelvis

Facility: Cook Childrens Medical Center Prosper

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $320
Cash Discount Price: $475
vs. Medicare Baseline: 3.00x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Cook Childrens Medical Center Prosper is $320. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $475. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.00x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$475

Average discount available for prompt cash payment at this facility.

Insurance Median

$320

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: $475 (445%)

Insurance Median: $320 (300%)

Cash: $475 (445% of Medicare)

Ins. Median: $320 (300% 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 300% of the Medicare baseline (a markup of 200%). 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
Aetna	$33 - $584	31%
Beacon	$135 - $371	126%
El Paso Health First	$135 - $371	126%
Health Plan W. Uhrip	$135	126%
Health Plan W/O Uhrip	$135 - $371	126%
Tx Children Health	$135 - $371	126%
Wellpoint	$141	132%
Blue Cross Blue Shield	$145 - $618	136%
Superior Health	$145	136%
Firstcare	$148 - $550	139%
United Community	$148 - $254	139%
UnitedHealthcare	$255 - $584	239%
S&W Health	$486 - $577	455%
Cigna	$492 - $584	461%
Healthscope	$492 - $584	461%
Imagine Health	$492 - $584	461%
Humana	$504 - $605	472%
Multiplan	$504 - $598	472%
First Health	$509 - $605	477%
Galaxy Health	$521 - $618	488%
Healthsmart	$521 - $618	488%
Usamco	$532 - $632	498%

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 $475.
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 Prosper 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.