X-ray, pelvis
Facility: Wichita County Health Center
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $366
- Cash Discount Price: $321
- vs. Medicare Baseline: 3.43x 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 343% of the Medicare baseline (a markup of 243%). 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 |
|---|---|---|
| Medicaid / KanCare | $331 | 310% |
| UnitedHealthcare | $401 | 375% |
Consumer Guidance & Cost Commentary
For this X-ray of the pelvis at Wichita County Health Center in Leoti, Kansas, the facility's cash price is $321.00, which is lower than the median amount paid by insurance ($331.00) and the negotiated rate ($366.00). While the gross charge is $401.00, patients with high-deductible plans might find paying the cash price directly more affordable than relying on insurance, as the insurer's allowed amount could exceed the cash rate. The facility is a government-owned Critical Access Hospital, and while specific county or state average pricing data is not provided in this report, the cash price remains a strong baseline for comparison against the facility's own negotiated and paid rates.
The Medicare benchmark for this service is $106.81, which serves as a cost-based baseline to evaluate the facility's pricing structure. The cash price of $321.00 represents a significant markup over the Medicare rate, a common dynamic where commercial rates reflect administrative costs and profit margins beyond the federal reimbursement standard. If you are self-pay, it is advisable to ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as paying upfront can sometimes reduce the final amount owed. Additionally, if you have insurance, ensure you understand your deductible status, as the facility may bill you the full negotiated rate if your plan has not yet met that threshold.