CMS Price Transparency Data

X-ray, pelvis

Facility: Prosser Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $39
Cash Discount Price: $26
vs. Medicare Baseline: 0.37x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Prosser Memorial Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.37x the Medicare baseline. Located in 723 Memorial Street, Prosser, WA.

Cash / Self-Pay

$26

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $26 (24%)

Insurance Median: $39 (37%)

Cash: $26 (24% of Medicare)

Ins. Median: $39 (37% 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
Amerigroup	$5 - $135	5%
Community Health Plan Of Washington	$5 - $128	5%
Coordinated Care	$5 - $128	5%
Kaiser Permanente	$5 - $484	5%
Molina	$5 - $128	5%
UnitedHealthcare	$5 - $252	5%
Health Alliance Northwest	$9 - $79	8%
Humana	$9 - $268	8%
Wellcare	$9 - $79	8%
Aetna	$10 - $268	9%
Cigna	$10 - $258	9%
Premera	$11 - $252	10%
Asuris	$12 - $284	11%
Health Management Adminstrators	$12 - $284	11%
Regence	$12 - $284	11%
Ambetter / Centene	$17 - $243	16%
Multiplan	$39 - $284	37%
First Choice	$268	251%

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 $26.
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 Prosser Memorial 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.