CMS Price Transparency Data

X-ray, pelvis

Facility: Perry County Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $238
Cash Discount Price: $284
vs. Medicare Baseline: 2.23x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Perry County Memorial Hospital is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $284. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.23x the Medicare baseline. Located in 8885 Sr 237, Tell City, IN.

Cash / Self-Pay

$284

Average discount available for prompt cash payment at this facility.

Insurance Median

$238

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: $284 (266%)

Insurance Median: $238 (223%)

Cash: $284 (266% of Medicare)

Ins. Median: $238 (223% 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 223% of the Medicare baseline (a markup of 123%). 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	$54 - $405	51%
Veterans Administration	$101 - $405	95%
Bc 130	$105 - $324	98%
Group Insurance	$105 - $405	98%
Medicare (plans)	$105	98%
Workers Compensation	$202	189%
Nsa	$238 - $250	223%
Guarantor Liable	$284 - $405	266%
Pcmh Insurnace	$316 - $405	296%
Secondary Insurance	$324	303%
UnitedHealthcare	$324	303%
Operating Engineers	$344	322%
Boilermakers Healthcare	$352	330%
Cigna	$352	330%
Great West	$352 - $405	330%
Sagxxxx	$352	330%
Champus	$405	379%
Ngs American, Inc	$405	379%
Patoka Valley	$405	379%
Southwire	$405	379%
Tricare	$405	379%
Wausau Benefits	$405	379%

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 $284.
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 Perry 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.