CMS Price Transparency Data

X-ray, pelvis

Facility: Shenandoah Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $90
Cash Discount Price: $174
vs. Medicare Baseline: 0.84x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Shenandoah Medical Center is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.84x the Medicare baseline. Located in 300 Pershing Avenue, Shenandoah, IA.

Cash / Self-Pay

$174

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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: $174 (163%)

Insurance Median: $90 (84%)

Cash: $174 (163% of Medicare)

Ins. Median: $90 (84% 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
Blue Cross Blue Shield	$78	73%
Home State Health Plan Mcaid-All Plans	$88	82%
Molina Mcd	$88	82%
Nebraska Total Care Mcaid-All Plans	$88	82%
UnitedHealthcare	$88 - $262	82%
Iowa Total Care Mcaid-All Plans	$89	83%
Amerigroup Mcaid-All Plans	$90	84%
Triwest Wellmark - All Plans	$90	84%
Aetna	$91 - $256	85%
Molina Mcr - All Other Plans	$91	85%
Tricare	$91	85%
Wellcare Mcr Adv - All Plans	$91	85%
Midlands Choice-All Plans	$248	232%

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 $174.
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 Shenandoah Medical 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.