X-ray, pelvis
Facility: Overland Park Reg Med Ctr
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $345
- Cash Discount Price: $1,646
- vs. Medicare Baseline: 3.23x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 323% of the Medicare baseline (a markup of 223%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Multiplan | $30 - $1,276 | 28% |
| Blue Cross Blue Shield | $31 - $741 | 29% |
| Humana | $33 - $42 | 31% |
| Aetna | $33 - $879 | 31% |
| Corvel Corporation | $36 - $1,120 | 34% |
| Oha Network | $37 - $862 | 35% |
| Amerigroup | $60 | 56% |
| United | $60 - $776 | 56% |
| Healthyblue | $61 | 57% |
| Unicare | $62 | 58% |
| Medicaid / KanCare | $62 | 58% |
| Home State Health Plan | $95 | 89% |
| Cigna | $122 - $181 | 114% |
| Ambetter / Centene | $292 - $321 | 273% |
| Nhc Advantage | $298 - $328 | 279% |
| Wppa Providrs Care Network | $313 - $345 | 293% |
| Universal Healthcare | $549 - $603 | 514% |
| Coventry | $630 - $693 | 590% |
| Coventry Kc Mo | $643 - $707 | 602% |
| College Park Family Care Center | $674 - $741 | 631% |
| Focus Healthcare Mgmt, Inc | $1,175 - $1,293 | 1100% |
| Cco, Inc. | $1,175 - $1,293 | 1100% |
| Triwest Health Alliance | $1,175 - $1,293 | 1100% |
Consumer Guidance & Cost Commentary
For the X-ray of the pelvis (CPT 72170) at Overland Park Reg Med Ctr in Kansas, the cash price is $1,646.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $106.81, reflecting a markup of 3.2 times the federal baseline. While commercial insurance plans negotiate lower rates—ranging from $30 to $1,293 depending on the carrier—these negotiated amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying the cash rate directly can be more cost-effective than relying on insurance, as the insurer may only cover a portion of the negotiated fee after the deductible is met. Patients should verify their specific plan's allowed amount and consider requesting a self-pay or prompt-pay discount before scheduling to potentially reduce the final cost.
It is important to distinguish between the facility's gross charges and the actual amounts billed to patients. Although the data shows a median negotiated rate of $345.00 across various payers, this figure represents the maximum allowed amount under contract, not necessarily the final out-of-pocket cost for every member. Balance billing can still occur if a patient receives out-of-network services, such as certain lab tests or physician visits, where the provider bills the difference between their full chargemaster rate and the insurance payment. To avoid unexpected bills, patients should request an itemized bill before paying and dispute any charges for services not rendered or unbundled components. Additionally, under federal protections like the No Surprises Act, balance billing for emergency care or non-emergency services at in-network facilities is generally