CMS Price Transparency Data

X-ray, pelvis

Facility: Cass County Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $88
Cash Discount Price: $144
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Cass County Memorial Hospital is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $144. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.82x the Medicare baseline. Located in 1501 East Tenth Street, Atlantic, IA.

Cash / Self-Pay

$144

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $144 (135%)

Insurance Median: $88 (82%)

Cash: $144 (135% of Medicare)

Ins. Median: $88 (82% 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
Midlands Choice Medica Mcr	$41	38%
Triwest - All Plans	$84	79%
Aetna	$87 - $196	81%
Amerigroup Mcr Adv - All Other Plans	$87	81%
Medica Mcr Adv	$87	81%
Tricare	$87	81%
UnitedHealthcare	$87 - $151	81%
Va Ccn - All Plans	$87	81%
Wellmark Mcr Adv	$87	81%
Iowa Total Care Mcaid	$88	82%
Iowa Total Care Mcr	$88	82%
Molina Mcaid - All Plans	$88	82%
American Hlth Mcr Adv - All Plans	$89	83%
Medicaid / KanCare	$89	83%
Iowa Total Care Comm - All Other Plans	$95	89%
Wellmark Hmo	$109	102%
Wellmark Ppo - All Other Plans	$120	112%
Midlands Choice New Bus	$134	125%
Medica Comm - All Other Plans	$181	169%
Midlands Choice Pho (Ppo) - All Other Plans	$185	173%
Multiplan - All Plans	$196	184%

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 $144.
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 Cass County Memorial 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.