CMS Price Transparency Data

X-ray, pelvis

Facility: Intermountain Health Sanpete Valley Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $351
  • Cash Discount Price: $277
  • vs. Medicare Baseline: 3.29x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Intermountain Health Sanpete Valley Hospital is $351. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $277. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.29x the Medicare baseline. Located in 1100 South Medical Drive, Mount Pleasant, UT.
Cash / Self-Pay
$277

Average discount available for prompt cash payment at this facility.

Insurance Median
$351

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: $277 (259%)
Insurance Median: $351 (329%)
Cash: $277 (259% of Medicare)
Ins. Median: $351 (329% 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 329% of the Medicare baseline (a markup of 229%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 - $355 7%
American Health $8 - $111 7%
Blue Cross Blue Shield $8 - $351 7%
Health Partners Of Nevada $8 - $111 7%
Health Plan Of Nevada $8 - $329 7%
Healthy U $8 - $329 7%
Humana $8 - $351 7%
Molina $8 - $351 7%
Selecthealth $8 - $351 7%
UnitedHealthcare $8 - $351 7%
Triwest $115 - $334 108%
Awh Connected $186 - $355 174%
Byu Athletics $186 - $351 174%
Campbell Scientific $186 - $351 174%
Cigna $186 - $351 174%
Deseret Mutual $186 - $351 174%
Emi $186 - $351 174%
Emi Health $186 - $351 174%
Franklin County $186 - $351 174%
Health Utah $186 - $351 174%
Ifit $186 - $351 174%
Juniper Systems $186 - $351 174%
Lw Miller $186 - $351 174%
Managed Care Admin $186 - $351 174%
Motivhealth $186 - $351 174%
Pehp $186 - $351 174%
Prodegi Corp Benefit $186 - $351 174%
Tanner Llc $186 - $351 174%
Utah Tech $186 - $351 174%
Wise Network $186 - $351 174%
Injury Care Of Nevada $277 259%
Byu Risk Management $314 294%
Corporation Of The President $314 294%
Corvel Corporation $314 294%
Wcf Insurance $314 294%
Global Excel $351 329%
Hygeia Corporation $351 329%
Medcare International $351 329%
Springtide $351 329%
Uofu $351 329%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 South Medical Drive, Mount Pleasant, UT 84647
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals