CMS Price Transparency Data

X-ray, pelvis

Facility: Texas Childrens Hospital North Austin Campus

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $460
Cash Discount Price: $482
vs. Medicare Baseline: 4.31x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Texas Childrens Hospital North Austin Campus is $460. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $482. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.31x the Medicare baseline. Located in 9835 North Lake Creek Parkway Bldg A, Austin, TX.

Cash / Self-Pay

$482

Average discount available for prompt cash payment at this facility.

Insurance Median

$460

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: $482 (451%)

Insurance Median: $460 (431%)

Cash: $482 (451% of Medicare)

Ins. Median: $460 (431% 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 431% of the Medicare baseline (a markup of 331%). 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
Superior Chip	$28 - $29	26%
Driscoll Children'S Health Plan Mcd	$31	29%
First Care Health Plan	$194 - $460	182%
UnitedHealthcare	$194 - $460	182%
Molina Mcd	$216	202%
Blue Cross Blue Shield	$252 - $453	236%
Community Health Choice	$254 - $460	238%
Community First Health Plan Mcd	$288	270%
Cook Children'S Health Plan	$288	270%
Cigna	$410 - $460	384%
Aetna	$460	431%
Kelseycare	$467	437%
Healthsmart	$503	471%
Evolutions Healthcare	$539	505%
First Health	$633 - $683	593%
Multiplan	$647	606%
Galaxy Health Network	$683	639%

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 $482.
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 Texas Childrens Hospital North Austin Campus 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.