X-ray, pelvis
Facility: Mcpherson Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $64
- Cash Discount Price: $53
- vs. Medicare Baseline: 0.60x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Tricare | $7 - $85 | 7% |
| UnitedHealthcare | $7 - $360 | 7% |
| Wellcare Mcr Adv - All Plans | $8 - $96 | 7% |
| Aetna | $8 - $360 | 7% |
| Humana | $8 - $96 | 7% |
| Va Ccn - All Plans | $8 - $96 | 7% |
| Blue Cross Blue Shield | $8 - $96 | 7% |
| Ambetter / Centene | $8 - $111 | 7% |
| Healthy Blue Mcr Adv | $8 - $96 | 7% |
| Multiplan - All Plans | $10 - $324 | 9% |
| Medicaid / KanCare | $22 - $360 | 21% |
| Health Blue Mcaid - All Other Plans | $23 - $367 | 22% |
| Medical Associates - All Plans | $44 - $270 | 41% |
| Central Plains - All Plans | $44 - $270 | 41% |
| Wppa - All Plans | $47 - $252 | 44% |
| Christian Health Aid - All Plans | $54 - $288 | 51% |
| Cigna | $55 - $342 | 51% |
| Health Partners - All Plans | $55 - $342 | 51% |
| First Health - All Plans | $64 - $342 | 60% |
Consumer Guidance & Cost Commentary
For this X-ray of the pelvis at McPherson Hospital, the cash median price is $53.00, which is lower than the facility's negotiated rate of $64.00 and the Medicare benchmark of $106.81. When compared to the state of Kansas, the facility's cash rate is significantly below the state average, while its negotiated rates for major payers like UnitedHealthcare and Aetna range from $7 to $360, reflecting the variability in commercial contracts. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $53.00 cash rate is lower than the negotiated amounts many insurers would allow, effectively bypassing the administrative markup that inflates commercial billing.
To ensure you are receiving the most accurate pricing, it is recommended to request an itemized billing audit before finalizing payment, as summary bills often obscure individual code costs and potential errors. Additionally, you should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if settled upfront, avoiding the costs associated with insurance claims processing. While the facility is an acute care hospital in Mcpherson, KS, with a voluntary non-profit ownership structure, verifying your specific plan's allowed amount is crucial, as assuming in-network status guarantees the lowest price can lead to unexpected costs if your deductible has not yet been met.