CMS Price Transparency Data

X-ray, pelvis

Facility: Charleston Area Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $435
Cash Discount Price: $541
vs. Medicare Baseline: 4.07x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Charleston Area Medical Center is $435. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $541. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.07x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$541

Average discount available for prompt cash payment at this facility.

Insurance Median

$435

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: $541 (507%)

Insurance Median: $435 (407%)

Cash: $541 (507% of Medicare)

Ins. Median: $435 (407% 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 407% of the Medicare baseline (a markup of 307%). 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
Aetna	$13 - $576	12%
The Health Plan Of West Virginia Inc.	$13 - $570	12%
Unicare Health Plan Of West Virginia Inc.	$13	12%
Triwest Va	$104	97%
Blue Cross Blue Shield	$107 - $536	100%
Choicecare Network	$107 - $576	100%
Optimum Choice Inc.	$107	100%
UnitedHealthcare	$110 - $576	103%
West Virginia Senior Advantage Inc.	$112	105%
Integrated Medical Solutions	$208	195%
Naphcare	$214	200%
Tricare	$266 - $353	249%
Caresource	$267	250%
City Of Charleston	$333 - $441	312%
Cigna	$413 - $547	387%
Three Rivers Providers Network	$431 - $570	404%
Healthsmart	$435 - $576	407%
Multiplan	$435 - $576	407%

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 $541.
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 Charleston Area 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.