CMS Price Transparency Data

X-ray, pelvis

Facility: Franciscan Health Lafayette

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $491
Cash Discount Price: $225
vs. Medicare Baseline: 4.60x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Franciscan Health Lafayette is $491. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.60x the Medicare baseline. Located in 1701 S Creasy Ln, Lafayette, IN.

Cash / Self-Pay

$225

Average discount available for prompt cash payment at this facility.

Insurance Median

$491

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: $225 (211%)

Insurance Median: $491 (460%)

Cash: $225 (211% of Medicare)

Ins. Median: $491 (460% 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 460% of the Medicare baseline (a markup of 360%). 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	$50 - $409	47%
Unicare [1150]	$50 - $409	47%
Mdwise [1175]	$54	51%
Medicaid / KanCare	$54 - $65	51%
Managed Health Services [1302]	$55	51%
Medicare (plans)	$111	104%
Workers Comp [1172]	$221	207%
Aetna	$250 - $720	234%
Managed Care [2000]	$250 - $915	234%
UnitedHealthcare	$442 - $541	414%
Commercial [2001]	$481 - $1,017	450%
United Medical Resources [1158]	$491	460%
United Medical Resources [1301]	$491 - $541	460%
Humana	$686	642%
Cigna	$699 - $814	654%
Great West Insurance [1055]	$699	654%

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 $225.
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 Franciscan Health Lafayette 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.