X-ray, pelvis
Facility: Lmh
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $105
- Cash Discount Price: $92
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Medicare (plans) | $39 - $105 | 37% |
| Humana | $39 - $105 | 37% |
| Cigna | $39 - $246 | 37% |
| UnitedHealthcare | $39 - $244 | 37% |
| Haskell Indian Health Services | $46 - $105 | 43% |
| Blue Cross Blue Shield | $46 - $238 | 43% |
| Allwell | $47 - $107 | 44% |
| Ambetter / Centene | $47 - $163 | 44% |
| Aetna | $234 - $305 | 219% |
| Non Contracted | $294 | 275% |
| First Health | $342 | 320% |
Consumer Guidance & Cost Commentary
For this X-ray of the pelvis at Lmh in Lawrence, KS, the facility's cash price of $92.00 is significantly lower than the gross charge of $368.00 and aligns closely with the state average. While Medicare reimbursement for this service is set at $106.81, the cash rate offers a more affordable option for patients who may have high deductibles or are uninsured. It is important to note that commercial insurance plans often negotiate rates higher than cash prices; for instance, UnitedHealthcare and Blue Cross Blue Shield have negotiated ranges extending up to $246 and $238 respectively, which can exceed the cash amount. Patients should verify their specific plan's deductible status before relying on insurance, as paying the full negotiated rate without meeting the deductible can result in higher out-of-pocket costs than paying cash directly.
To minimize potential billing surprises, patients should request a prompt-pay discount or self-pay rate before scheduling, as these upfront payments can bypass administrative fees and reduce the final bill. If you receive a bill after insurance processing, it is crucial to demand a full itemized audit rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Under federal protections like the No Surprises Act, you are generally shielded from balance billing for out-of-network providers at in-network facilities, but you should still review your statement line-by-line to ensure no unexpected charges exist. Finally, since this facility is government-owned, you may be eligible for additional financial assistance programs that could further reduce the cost of care.