CMS Price Transparency Data

X-ray, pelvis

Facility: Warner Hospital and Health Services

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $270
Cash Discount Price: $346
vs. Medicare Baseline: 2.53x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Warner Hospital and Health Services is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $346. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.53x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$346

Average discount available for prompt cash payment at this facility.

Insurance Median

$270

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: $346 (324%)

Insurance Median: $270 (253%)

Cash: $346 (324% of Medicare)

Ins. Median: $270 (253% 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 253% of the Medicare baseline (a markup of 153%). 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
Blue Cross Blue Shield	$137 - $339	128%
Aetna	$142 - $294	133%
Health Alliance Med Adv	$142	133%
Humana	$142 - $294	133%
Molina Mcr/Mcd Dual	$142	133%
UnitedHealthcare	$142 - $294	133%
Wellcare Mcr Adv-All Plans	$142	133%
Harmony Hp Mcaid-All Plans	$213	199%
Medicaid / KanCare	$213	199%
Meridian Hp-All Plans	$213	199%
Molina-All Other Plans	$213	199%
Healthlink Hmo	$270	253%
City Of Clinton (Employees Serv)-All Plans	$277	259%
Cigna	$287	269%
Caterpillar-All Plans	$294	275%
Multiplan Phcs-All Plans	$294	275%
Health Alliance-All Other Plans	$304	285%
Healthlink Ppo/Work Comp-All Other Plans	$304	285%
Consociate Care Ppo-All Plans	$311	291%
Hfn Ppo/Epo-All Plans	$311	291%
Three Rivers-All Plans	$328	307%

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 $346.
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 Warner Hospital and Health Services 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.