X-ray, pelvis
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $96
- Cash Discount Price: $239
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Humana | $94 | 88% |
| Blue Cross Blue Shield | $95 - $96 | 89% |
| Aetna | $96 - $120 | 90% |
| UnitedHealthcare | $96 - $116 | 90% |
| Providrs Care Network | $96 | 90% |
| United Mine Workers Of America | $96 | 90% |
| Lantern Specialty Care | $153 | 143% |
Consumer Guidance & Cost Commentary
For this X-ray, pelvis procedure at Kansas Spine & Specialty Hospital, Llc in Wichita, KS, the cash median price is $239.00, which is lower than the facility's gross charge of $368.00. While the facility is physician-owned, patients should note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, the median negotiated rate across payers is $96.00, yet individual plans show a wide range, with Aetna plans ranging from $96 to $120 and UnitedHealthcare from $96 to $116. If you have a high-deductible plan, paying the cash price of $239.00 upfront might be more cost-effective than relying on insurance, especially if your deductible has not yet been met or if the insurer's allowed amount is lower than the cash rate.
To understand the true cost relative to the healthcare system, it is important to compare these rates against the Medicare benchmark. The Medicare amount for this service is $106.81, and the facility's vs_medicare ratio is 0.9, indicating the cash price is slightly below the Medicare benchmark. This suggests the facility is pricing competitively compared to the federal cost baseline, which serves as the objective standard for evaluating hospital markups. Additionally, patients should inquire about "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payments, bypassing the administrative costs associated with insurance claims processing. Always request an itemized bill before paying to ensure no errors or unbundled charges are included, as over 80%