CMS Price Transparency Data

X-ray, pelvis

Facility: St Anthony Regional Hospital & Nursing Home

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $73
Cash Discount Price: $343
vs. Medicare Baseline: 0.68x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at St Anthony Regional Hospital & Nursing Home is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $343. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.68x the Medicare baseline. Located in 311 South Clark Street, Carroll, IA.

Cash / Self-Pay

$343

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $343 (321%)

Insurance Median: $73 (68%)

Cash: $343 (321% of Medicare)

Ins. Median: $73 (68% 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
Humana	$29 - $292	27%
Medica Mcr - All Plans	$29	27%
UnitedHealthcare	$29 - $276	27%
Va Ccn - All Plans	$29	27%
Wellpoint Mcr Adv	$29	27%
Ia Total Care Mcaid	$33	31%
Molina Mcaid - All Plans	$34	32%
Wellmark Hmo	$60	56%
Wellmark Ppo-All Other Plans	$65	61%
Aetna	$73 - $274	68%
Ia Total Care Mcr	$127	119%
Wellpoint Mcaid - All Other Plans	$141	132%
Ia Total Care Comm - All Other Plans	$161	151%
Midlands Choice - All Plans	$322	301%

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 $343.
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 St Anthony Regional Hospital & Nursing Home 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.