CMS Price Transparency Data

X-ray, pelvis

Facility: Intermountain Health Spanish Fork Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $198
  • Cash Discount Price: $308
  • vs. Medicare Baseline: 1.85x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Intermountain Health Spanish Fork Hospital is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $308. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.85x the Medicare baseline. Located in 765 East Market Place Drive, Spanish Fork, UT.
Cash / Self-Pay
$308

Average discount available for prompt cash payment at this facility.

Insurance Median
$198

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: $308 (288%)
Insurance Median: $198 (185%)
Cash: $308 (288% of Medicare)
Ins. Median: $198 (185% 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
Aetna $8 - $349 7%
American Health $8 - $109 7%
Blue Cross Blue Shield $8 - $312 7%
Health Partners Of Nevada $8 - $105 7%
Health Plan Of Nevada $8 - $123 7%
Healthy U $8 - $105 7%
Humana $8 - $110 7%
Molina $8 - $116 7%
Selecthealth $8 - $1,199 7%
UnitedHealthcare $8 - $349 7%
Donor Connect $27 - $111 25%
Triwest $102 95%
Intermountain Caregiver Plan $174 - $1,142 163%
Awh Connected $175 - $267 164%
Byu Athletics $186 - $296 174%
Campbell Scientific $186 - $296 174%
Deseret Mutual $186 - $236 174%
Emi $186 - $222 174%
Emi Health $186 - $285 174%
Franklin County $186 - $296 174%
Ifit $186 - $296 174%
Juniper Systems $186 - $296 174%
Lw Miller $186 - $296 174%
Pehp $186 - $365 174%
Tanner Llc $186 - $296 174%
Utah Tech $186 - $296 174%
Cigna $259 - $349 242%
Byu Risk Management $287 - $300 269%
Corporation Of The President $287 - $300 269%
Wcf Insurance $287 - $300 269%
Corvel Corporation $296 277%
Injury Care Of Nevada $308 288%
Managed Care Admin $320 300%
Prodegi Corp Benefit $337 316%
Uofu $337 316%
Springtide $341 319%
Global Excel $349 327%
Medcare International $349 327%
Motivhealth $349 327%
Wise Network $349 327%
Hygeia Corporation $369 345%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 765 East Market Place Drive, Spanish Fork, UT 84660
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals