CMS Price Transparency Data

X-ray, pelvis

Facility: Mercyone Elkader Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $257
  • Cash Discount Price: $227
  • vs. Medicare Baseline: 2.41x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Mercyone Elkader Medical Center is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $227. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.41x the Medicare baseline. Located in 901 Davidson Street Nw, Elkader, IA.
Cash / Self-Pay
$227

Average discount available for prompt cash payment at this facility.

Insurance Median
$257

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: $227 (213%)
Insurance Median: $257 (241%)
Cash: $227 (213% of Medicare)
Ins. Median: $257 (241% 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 241% of the Medicare baseline (a markup of 141%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $180 169%
Aetna $181 - $257 169%
Medicare (plans) $183 - $189 171%
UnitedHealthcare $192 - $262 180%
Iowa Total Care $217 203%
Medicaid / KanCare $220 - $221 206%
Amish Hospital Aid $241 226%
1199 National Benefit Fund $257 241%
Allied Benefit Systems $257 241%
Asr Health Benefits $257 241%
Christian Brother Services $257 241%
Coventry $257 241%
First Health $257 241%
Lucent Health $257 241%
Luminare Health $257 241%
Medical Mutual $257 241%
Meritain $257 241%
Trustmark Small Business Benefits $257 241%
Webtpa $257 241%
Geha $262 245%
Centivo $272 255%
Health Choices $279 261%
Medical Associates $279 261%
Ambetter / Centene $305 286%
Health Partners $336 315%
Auxiant $342 320%
Cigna $342 320%
Medica $342 320%
Midlands $342 320%
Midlands Choice $342 320%
Crime Victim Assistance $349 327%
Iowa Dept Of Public Health $349 327%
Claimdoc $365 342%
Nova $365 342%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 Davidson Street Nw, Elkader, IA 52043
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals