CMS Price Transparency Data

X-ray, pelvis

Facility: Anderson Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $250
Cash Discount Price: $273
vs. Medicare Baseline: 2.34x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Anderson Hospital is $250. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $273. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.34x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.

Cash / Self-Pay

$273

Average discount available for prompt cash payment at this facility.

Insurance Median

$250

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: $273 (256%)

Insurance Median: $250 (234%)

Cash: $273 (256% of Medicare)

Ins. Median: $250 (234% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 234% of the Medicare baseline (a markup of 134%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$16 - $70	15%
Health Care Service Corporation	$23 - $250	22%
Tricare	$26 - $4,572	24%
Humana	$27 - $4,767	25%
Medicare (plans)	$27 - $4,767	25%
UnitedHealthcare	$27 - $4,767	25%
Aetna	$31 - $4,767	29%
Work Comp	$74 - $26,600	69%
Healthlink	$80	75%
Devoted Health Ppo	$112 - $4,863	105%
Essence	$112 - $5,010	105%
Clear Springs Health	$114 - $4,910	107%
Ambetter / Centene	$162 - $7,053	152%
Blue Choice	$162 - $7,053	152%
Self Pay	$273 - $25,000	256%
Hopetrust	$280 - $12,160	262%
Blue Cross Blue Shield	$293 - $304	274%
Mercy Aco	$355	332%
Mercy Benefit Admin	$355	332%
Cigna	$382	358%
Multiplan/Phcs	$410	384%
Beech Street Corporation	$492	461%

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 $273.
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 Anderson 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.