CMS Price Transparency Data

X-ray, pelvis

Facility: Springfield Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $546
Cash Discount Price: $514
vs. Medicare Baseline: 5.11x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Springfield Hospital is $546. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $514. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.11x the Medicare baseline. Located in Po Box 2003, Springfield, VT.

Cash / Self-Pay

$514

Average discount available for prompt cash payment at this facility.

Insurance Median

$546

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: $514 (481%)

Insurance Median: $546 (511%)

Cash: $514 (481% of Medicare)

Ins. Median: $546 (511% 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 511% of the Medicare baseline (a markup of 411%). 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
Blue Cross Blue Shield	$256 - $694	240%
Mvp Health Plan	$256 - $534	240%
UnitedHealthcare	$256 - $625	240%
Wellsense	$256 - $694	240%
Harvard Pilgrim Health Care	$259 - $574	242%
Wellcare	$264 - $272	247%
Tufts Health Plan	$414 - $426	388%
Cigna	$473 - $722	443%
Multiplan	$559 - $576	523%
Aetna	$640 - $659	599%
Coventry	$640 - $659	599%
Beacon Health	$674 - $694	631%
Manage Behavioral Health	$674 - $694	631%
Martin'S Point Healthcare	$674 - $694	631%

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 $514.
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 Springfield Hospital 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.