CMS Price Transparency Data

X-ray, pelvis

Facility: Henry County Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $113
Cash Discount Price: $261
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Henry County Memorial Hospital is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $261. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.06x the Medicare baseline. Located in 1000 N 16Th St, New Castle, IN.

Cash / Self-Pay

$261

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $261 (244%)

Insurance Median: $113 (106%)

Cash: $261 (244% of Medicare)

Ins. Median: $113 (106% 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
UnitedHealthcare	$7 - $362	7%
Aetna	$8 - $378	7%
Blue Cross Blue Shield	$8 - $340	7%
Caresource Hip	$8 - $112	7%
Caresource Mcr Adv	$8 - $114	7%
Humana	$8 - $392	7%
Caresource Marketplace-All Other Plans	$11 - $213	10%
Caresource Just4Me	$12 - $280	11%
Caresource Mcaid	$14 - $26	13%
Encore Workers Comp-All Plans	$14 - $423	13%
Cigna	$36 - $303	34%
Health Alliance-All Plans	$61 - $378	57%
Workers Comp - All Plans	$65 - $400	61%

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 $261.
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 Henry 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.