CMS Price Transparency Data

X-ray, pelvis

Facility: Boone County Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $31
Cash Discount Price: $32
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Boone County Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.29x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$32

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: $32 (30%)

Insurance Median: $31 (29%)

Cash: $32 (30% 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.

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
Aetna	$14 - $36	13%
Amerigroup Mcr Adv - All Other Plans	$14 - $104	13%
Choice Care Mcr Adv - All Plans	$14 - $103	13%
Humana	$14 - $226	13%
Iowa Hlth Adv - All Plans	$14 - $103	13%
Mt Carmel Hp - All Plans	$14 - $103	13%
UnitedHealthcare	$14 - $27	13%
Va Ccn-All Plans	$14 - $19	13%
Meridian Mcaid - All Plans	$15 - $113	14%
Iowa Total Care Mcaid - All Plans	$16 - $21	15%
Medicaid / KanCare	$16 - $116	15%
Healthsmart Accell Network	$24 - $32	22%
Medical Associates Hp-All Plans	$26 - $188	24%
Healthsmart Ppo - All Other Plans	$27 - $201	25%
Health Alliance-All Plans	$31 - $41	29%
Midlands Choice-All Plans	$31 - $231	29%
Mutually Preferred-All Plans	$32 - $239	30%
Wellmark Hmo	$58	54%
Wellmark Ppo - All Other Plans	$64	60%
Tricare	$107	100%

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 $32.
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 Boone County Hospital 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.