X-ray, pelvis
Facility: Lane County Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $204
- Cash Discount Price: $204
- vs. Medicare Baseline: 1.91x 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 |
|---|---|---|
| UnitedHealthcare | $183 - $204 | 171% |
| Aetna | $183 - $193 | 171% |
| Healthy Blue Mcaid | $204 | 191% |
| Medicaid / KanCare | $204 - $224 | 191% |
| Healthy Blue Mcr Adv - All Other Plans | $204 | 191% |
| Wppa Providers-All Plans | $305 | 286% |
Consumer Guidance & Cost Commentary
For the X-ray, pelvis procedure at Lane County Hospital in Dighton, KS, the cash and negotiated rates are identical at $204.00, which is significantly higher than the state average of $106.81 (Medicare amount). While commercial payers like UnitedHealthcare and Aetna negotiate rates ranging from $183 to $204, these amounts remain above the Medicare benchmark. Because the cash price matches the negotiated rate, patients with high-deductible plans may find paying out-of-pocket directly is the most cost-effective option, potentially saving money compared to insurance processing. It is important to note that while the facility is a Critical Access Hospital owned by a Government Hospital District, the lack of a self-pay discount listed in the data suggests that upfront payment may not yield additional savings beyond the standard cash price.
This pricing structure highlights the importance of verifying your specific plan details before scheduling, as commercial rates often exceed the true cost of care represented by Medicare benchmarks. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, the high gap between the Medicare rate and commercial charges indicates that insurance administrative costs are driving up the final price. Consumers should request an itemized bill to ensure no unbundled codes or services not rendered are included, and if any balance billing occurs, they should dispute the amount with their insurer rather than paying immediately. Given that the facility's rates align with the highest end of the payer range, patients should carefully review their deductible status and consider whether a cash payment would result in a lower out-of-pocket expense than their insurance allowed amount.