X-ray, pelvis
Facility: Mercy Hospital Columbus
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $242
- Cash Discount Price: $217
- vs. Medicare Baseline: 2.27x 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 227% of the Medicare baseline (a markup of 127%). 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 |
|---|---|---|
| Centivo Contracted [320505] | $3 | 3% |
| Humana | $16 - $317 | 15% |
| Medicaid / KanCare | $16 - $242 | 15% |
| Blue Cross Blue Shield | $91 - $242 | 85% |
| UnitedHealthcare | $91 - $277 | 85% |
| Medicare (plans) | $100 - $252 | 94% |
| Insurance System Inc Contracted [320465] | $144 | 135% |
| Health Systems Inc Contracted [320174] | $144 | 135% |
| Administrative Payor Contracted [320005] | $150 | 140% |
| Cross Timbers Hospice [20098] | $242 | 227% |
| Mercy Hospice Okc [20252] | $242 | 227% |
| Dept Of Veteran Affairs Contracted [320106] | $242 | 227% |
| Cigna | $242 | 227% |
| Cherokee Nation Health Serv Contracted [320066] | $242 | 227% |
| Indian Health Service Contracted [320198] | $242 | 227% |
| Centurion Of Missouri [20459] | $242 | 227% |
| Home State Health Plan Contracted [320187] | $242 | 227% |
| Mercy Mgd Behavioral Health Contracted [320259] | $242 | 227% |
| Novasys Contracted [320285] | $242 | 227% |
| Qual Choice Contracted [320325] | $242 | 227% |
| Kindful Hospice Contracted [320434] | $242 | 227% |
| Aetna | $242 - $301 | 227% |
| Medical Associates Health Contracted [320444] | $242 | 227% |
| Kindful Hospice [20434] | $242 | 227% |
| Globalhealth Contracted [320145] | $242 | 227% |
| Provider Partners Health Plans Contracted [320450] | $242 | 227% |
| Ambetter / Centene | $242 | 227% |
| Pace Of The Ozarks Contracted [320518] | $242 | 227% |
| Halo Hcr Inc Hospice [20432] | $242 | 227% |
| Elara Caring Aspire Hospice [20433] | $242 | 227% |
| Halo Hcr Inc Hospice Contracted [320432] | $242 | 227% |
| Tricare | $243 | 228% |
| Healthscope Contracted [320182] | $258 | 242% |
| Workers Comp [20426] | $267 - $284 | 250% |
| United Medical Resources Contracted [320454] | $277 - $317 | 259% |
| Medica Contracted [320239] | $299 | 280% |
| Healthlink Contracted [320179] | $301 - $317 | 282% |
| Usa Managed Care Org Contracted [320429] | $301 | 282% |
| First Health Contracted [320128] | $301 | 282% |
| American Healthcare Alliance Contracted [320020] | $301 | 282% |
| Mercy Benefit Admin Contracted [320251] | $301 - $317 | 282% |
| Preferred Health Plan Contracted [320522] | $301 | 282% |
| Federal Medical Center Contracted [320127] | $301 | 282% |
| Yuzu Health Contracted [320521] | $317 | 297% |
| Imagine 360 Contracted [320494] | $317 | 297% |
| 90 Degree Benefits Contracted [320436] | $317 | 297% |
| Private Health Care Systems Contracted [320320] | $317 | 297% |
| Reflect Health Contracted [320492] | $317 | 297% |
| Aither Health Contracted [320449] | $317 | 297% |
| Ppo Plus Contracted [320310] | $317 | 297% |
| Point C Contracted [320238] | $317 | 297% |
| Benefit Management Contracted [320052] | $317 | 297% |
| Edison Health Solutions Contracted [320502] | $317 | 297% |
| Show-Me Health Administrators Contracted [320483] | $317 | 297% |
| Ebms Contracted [320493] | $317 | 297% |
| Auxiant Contracted [320462] | $317 | 297% |
Consumer Guidance & Cost Commentary
For the CPT code 72170 (X-ray, pelvis) at Mercy Hospital Columbus, the cash price is $334.00, which is notably higher than the facility's reported cash median of $217.00 and the state average of $213.00. While the gross charge listed is $334.00, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures; for instance, the median negotiated rate across payers is $242.00, with some plans ranging up to $317.00. If you have a high-deductible plan, paying the cash price of $217.00 directly may result in lower out-of-pocket costs compared to the insurance negotiated rate, provided you have not yet met your deductible. We recommend contacting the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these can further reduce the final amount owed.
To ensure you are receiving fair pricing, it is important to compare this facility's rates against the Medicare benchmark of $106.81, which serves as the objective baseline for healthcare costs. The commercial negotiated rates observed here average approximately 2.3 times the Medicare amount, reflecting standard market dynamics where commercial rates often range between 200% and 300% of Medicare. If you receive a summary bill that obscures individual line items, request a full itemized audit to identify potential errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies. Always verify your specific plan's allowed amount