CMS Price Transparency Data

X-ray, pelvis

Facility: Olympic Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $120
Cash Discount Price: $128
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Olympic Medical Center is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.12x the Medicare baseline. Located in 939 Caroline St, Port Angeles, WA.

Cash / Self-Pay

$128

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $128 (120%)

Insurance Median: $120 (112%)

Cash: $128 (120% of Medicare)

Ins. Median: $120 (112% 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.

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
Coordinated Care	$9 - $110	8%
Molina	$9 - $141	8%
Wellpoint (Formerly Amerigroup)	$9 - $115	8%
Community Health Plan Of Washington	$10 - $248	9%
UnitedHealthcare	$10 - $310	9%
Regence Uniform	$11 - $173	10%
Ambetter / Centene	$18 - $295	17%
Cigna	$19 - $302	18%
Aetna	$20 - $310	19%
First Choice Network	$20 - $310	19%
Gmr/Caldera Care	$20 - $310	19%
Hma	$20 - $310	19%
Lifewise	$20 - $310	19%
Premera	$20 - $310	19%
Regence	$20 - $310	19%
Wellcare	$58	54%

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 $128.
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 Olympic Medical Center 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.