CMS Price Transparency Data

X-ray, pelvis

Facility: Intermountain Health Delta Community Hospital

Billing Code: 72170 (CPT)

The BaseRate · fair price low confidence

A fair price for this

$105

about 1.0× the $107 Medicare rate · typically $21–$181

modeled estimate · not a bill or quote

What this hospital charges insurers

$102

About the fair price

about $3 under the fair price · 1.0× Medicare

Medicare pays $107 Fair price $105 This hospital $102 Cash price $277 Hospital's list price $369

How we calculate the fair BaseRate →

How this hospital compares to other UT hospitals

A typical price — 2 charge more and 5 charge less, among the 9 UT hospitals compared.

Cheapest $83 Priciest $105

Black dot = this hospital, among the 9 UT hospitals with a price for this procedure. Full list below.

A fair price for a X-ray, pelvis is about $105 (about 1.0× the $107 Medicare rate). Intermountain Health Delta Community Hospital charges insurers about $102, or about $277 in cash — about the fair price. Located in Delta, UT.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$8 - $351	7%
Blue Cross Blue Shieldmajor	$8 - $351	7%
Aetnamajor	$8 - $355	7%
Cignamajor	$186 - $351	174%
Humanamajor	$8 - $118	7%
HealthPartners	$8 - $118	7%
Molina	$8 - $351	7%
SelectHealth	$8 - $351	7%
+ 30 smaller / regional plans	$8 - $355

Government programs also on file: Military & VA.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 277), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 72170.

Insurance Before you use insurance

Call your insurance company to confirm Intermountain Health Delta Community Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 72170.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Intermountain Health Delta Community Hospital

Compare: X-ray, pelvis at other UT hospitals

Insurance negotiated median for the same procedure, sorted lowest first.