CMS Price Transparency Data

X-ray, pelvis

Facility: Jefferson County Health Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $31
  • Cash Discount Price: $40
  • vs. Medicare Baseline: 0.29x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Jefferson County Health Center is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.29x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$40

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $40 (37%)
Insurance Median: $31 (29%)
Cash: $40 (37% of Medicare)
Ins. Median: $31 (29% 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
UnitedHealthcare $23 - $60 22%
Tricare $26 24%
Amerigroup Mcr Adv $27 25%
Humana $27 25%
Iowa Total Care Comm - All Other Plans $27 25%
Iowa Total Care Mcr $27 25%
Molina Mcr Adv $27 25%
Iowa Total Care Mcaid $28 26%
Molina Mcaid/Chip $28 26%
Medicaid / KanCare $29 27%
Aetna $33 - $60 31%
Medicare (plans) $33 31%
Midlands New Product $55 51%
Coventry Commercial Hmo $57 53%
Wellmark Hmo $59 55%
Coventry Commercial Ppo - All Other Plans $60 56%
Midlands Choice-All Other Plans $60 56%
Wellmark Indemnity/Ppo - All Other Plans $65 61%
Molina Marketplace - All Other Plans $67 63%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals