CMS Price Transparency Data

X-ray, pelvis

Facility: Kenmore Mercy Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $19
  • Cash Discount Price: $265
  • vs. Medicare Baseline: 0.18x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Kenmore Mercy Hospital is $19. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $265. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.18x the Medicare baseline. Located in 2950 Elmwood Avenue, Kenmore, NY.
Cash / Self-Pay
$265

Average discount available for prompt cash payment at this facility.

Insurance Median
$19

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: $265 (248%)
Insurance Median: $19 (18%)
Cash: $265 (248% of Medicare)
Ins. Median: $19 (18% 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.

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
Univera Healthcare Essential [100170] $4 - $23 4%
Blue Cross Blue Shield $6 - $38 6%
UnitedHealthcare $6 - $27 6%
Crime Victims [100176] $7 - $18 7%
Beacon Essential [350122] $7 - $32 7%
Independent Health Essential [100166] $7 - $115 7%
VA Veterans Affairs [700001] $7 - $23 7%
Univera Healthcare [100169] $7 - $33 7%
Medicaid / KanCare $7 - $96 7%
Tuscarora Nation [550120] $7 - $18 7%
Excellus Rochester McD [350117] $7 - $18 7%
Vna Option Mltc [350110] $7 - $18 7%
Cigna $8 - $39 7%
Catholic Health Life Pace [400005] $8 - $27 7%
Medicare (plans) $8 - $139 7%
Fallon Health [450115] $8 - $27 7%
Seneca Nation [450119] $8 - $27 7%
Hospice [550001] $8 - $27 7%
Covid19 Hrsa [45013] $8 - $27 7%
Ghi [100153] $8 - $25 7%
Tricare $8 - $27 7%
Champ VA [700002] $8 - $27 7%
Aetna $9 - $28 8%
Fidelis Essential [100163] $9 - $29 8%
Independent Health [100165] $9 - $230 8%
Iha First Choice [800001] $9 - $229 8%
Fidelis Dual Advantage [450120] $9 - $28 8%
Humana $9 - $28 8%
Wellcare [450129] $9 - $29 8%
Wellcare Fidelis Dual [450451] $9 - $28 8%
Beacon Health Options [100023] $10 - $32 9%
Fidelis Exchange [100164] $10 - $32 9%
Mvp Healthcare [100168] $11 - $34 10%
Amerigroup [350102] $13 - $38 12%
UPMC Health Plan [100181] $15 - $48 14%
Molina Essential [100167] $17 - $40 16%
No Fault [114001] $27 - $68 25%
Federal Workers Compensation [500100] $27 - $68 25%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2950 Elmwood Avenue, Kenmore, NY 14217
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals