CMS Price Transparency Data

X-ray, pelvis

Facility: Mercyone Clinton Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $205
  • Cash Discount Price: $254
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Mercyone Clinton Medical Center is $205. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.92x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$254

Average discount available for prompt cash payment at this facility.

Insurance Median
$205

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: $254 (238%)
Insurance Median: $205 (192%)
Cash: $254 (238% of Medicare)
Ins. Median: $205 (192% 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
Iowa Total Care $96 90%
Medicaid / KanCare $97 - $98 91%
Bcn Domestic $107 100%
Blue Benefit Administrators Of Massachusetts $107 100%
Blue Care Network $107 100%
Blue Cross Blue Shield $107 - $110 100%
Blue Distinction Transplant $107 100%
Blue Shield - Ca $107 100%
Blue Shield - Id (Regence) $107 100%
Blue Shield - Ny Highmark Northeastern $107 100%
Blue Shield - Ny Highmark Western $107 100%
Blue Shield - Pa (Highmark) $107 100%
Blue Shield - Wa (Regence) $107 100%
Kaiser Domestic $107 100%
Pre-Employment $107 100%
Wc Domestic $107 100%
Aetna $109 - $341 102%
Medicare (plans) $109 - $114 102%
Health Choices $110 103%
Medical Associates $110 103%
UnitedHealthcare $111 - $390 104%
Preferred Health Choice $113 106%
Amish Hospital Aid $148 139%
Oscar $152 142%
Ambetter / Centene $187 175%
Claimdoc $224 210%
Nova $224 210%
The Alliance $237 222%
Geha $240 225%
1199 National Benefit Fund $341 319%
Allied Benefit Systems $341 319%
Asr Health Benefits $341 319%
Christian Brother Services $341 319%
Coventry $341 319%
First Health $341 319%
Lucent Health $341 319%
Luminare Health $341 319%
Medical Mutual $341 319%
Meritain $341 319%
Trustmark Small Business Benefits $341 319%
Webtpa $341 319%
Health Partners $342 320%
Auxiant $351 329%
Cigna $351 329%
Medica $351 329%
Midlands $351 329%
Midlands Choice $351 329%
Multiplan $351 329%
Qualcare $351 329%
Usa Managed Care $370 346%
Crime Victim Assistance $390 365%
Iowa Dept Of Public Health $390 365%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals