CMS Price Transparency Data

X-ray, pelvis

Facility: Waverly Health Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $150
Cash Discount Price: $120
vs. Medicare Baseline: 1.40x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Waverly Health Center is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.40x the Medicare baseline. Located in 312 9Th Street Sw, Waverly, IA.

Cash / Self-Pay

$120

Average discount available for prompt cash payment at this facility.

Insurance Median

$150

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: $120 (112%)

Insurance Median: $150 (140%)

Cash: $120 (112% of Medicare)

Ins. Median: $150 (140% 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
UnitedHealthcare	$87 - $161	81%
Choicecare Network - All Plans	$88	82%
Medicare (plans)	$99	93%
Midlands Choice Mcare	$99	93%
Wellmark Hmo	$128	120%
Wellmark Ppo - All Other Plans	$140	131%
Hlth Partners Bridges Ntwrk	$160	150%
Hlth Partners Open Ntwrk - All Other Plans	$160	150%
Aetna	$196	184%
Health Alliance-All Plans	$207	194%
Midlands Choice-All Other Plans	$207	194%

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 $120.
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 Waverly Health 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.