CMS Price Transparency Data

X-ray, pelvis

Facility: Iowa Specialty Hospital - Clarion

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $71
Cash Discount Price: $94
vs. Medicare Baseline: 0.66x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Iowa Specialty Hospital - Clarion is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.66x the Medicare baseline. Located in 1316 South Main Street, Clarion, IA.

Cash / Self-Pay

$94

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $94 (88%)

Insurance Median: $71 (66%)

Cash: $94 (88% of Medicare)

Ins. Median: $71 (66% 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
Tricare	$8 - $84	7%
Triwest Va - All Plans	$8 - $84	7%
Aetna	$9 - $231	8%
Healthscope Stellar-All Plans	$13 - $144	12%
Health Partners Ish-All Other Plans	$16 - $218	15%
Wellmark Hmo	$16 - $109	15%
Wellmark Ppo - All Other Plans	$18 - $120	17%
UnitedHealthcare	$22 - $258	21%
Auxiant Clarion Schools-All Plans	$26 - $177	24%
Health Partners Prestage	$30 - $204	28%
Cigna	$58 - $264	54%
Midlands Choice-All Plans	$58 - $264	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 $94.
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 Iowa Specialty Hospital - Clarion 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.