CMS Price Transparency Data

X-ray, pelvis

Facility: Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $279
  • Cash Discount Price: $248
  • vs. Medicare Baseline: 2.61x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Memorial Hospital is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $248. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.61x the Medicare baseline. Located in 1454 N County Road 2050 E, Carthage, IL.
Cash / Self-Pay
$248

Average discount available for prompt cash payment at this facility.

Insurance Median
$279

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: $248 (232%)
Insurance Median: $279 (261%)
Cash: $248 (232% of Medicare)
Ins. Median: $279 (261% 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 261% of the Medicare baseline (a markup of 161%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $80 - $310 75%
Aetna $87 - $310 81%
Blue Cross Blue Shield $87 - $310 81%
Cigna $87 - $310 81%
Health Alliance $87 - $310 81%
Meridian $87 - $310 81%
Molina $87 - $310 81%
UnitedHealthcare $87 - $310 81%
Consociate $264 - $310 247%
Healthlink $264 - $310 247%
Private Healthcare Systems $264 247%
Integrated Health Plan $273 256%
First Health Network $276 - $310 258%
Health Dynamics $279 261%
Health Payors Org $279 261%
Iowa Health Solutions $279 261%
Multiplan $279 261%
Preferred Plan Inc $279 261%
Three Rivers Provider Network $279 261%
Health First Network $282 264%
Pponext $282 264%
Corvel $294 275%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1454 N County Road 2050 E, Carthage, IL 62321
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals