X-ray, pelvis
Facility: Rooks County Health Center
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $188
- Cash Discount Price: $157
- vs. Medicare Baseline: 1.76x 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 |
|---|---|---|
| Tricare | $98 | 92% |
| Celtic Mcr Adv | $98 | 92% |
| Veterans Admin - All Plans | $98 | 92% |
| Celtic Comm - All Other Plans | $108 | 101% |
| Blue Cross Blue Shield | $133 | 125% |
| Preferred Benefits Admin | $188 | 176% |
| UnitedHealthcare | $188 | 176% |
| Aetna | $188 | 176% |
| Health Partners - All Plans | $199 | 186% |
| Preferred Hlthcare - All Other Plans | $199 | 186% |
| Healthy Blue Mcaid - All Plans | $209 | 196% |
Consumer Guidance & Cost Commentary
For the X-ray, pelvis procedure (CPT 72170) at Rooks County Health Center in Plainville, KS, the facility's cash price of $157.00 is lower than the median negotiated rate of $188.00 paid by most insurance plans, including Tricare, UnitedHealthcare, and Aetna. While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans may find paying the cash price upfront more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
The facility's cash rate of $157.00 is also significantly lower than the Medicare benchmark of $106.81 when adjusted for the 1.8x vs. Medicare multiplier shown in the data, indicating that the commercial negotiated rates of $188.00 represent a substantial markup over the federal baseline. Although the data does not provide specific state or county average comparisons for this specific code, the structure of the billing suggests that commercial contracts often inflate costs above the true cost of care reflected in Medicare rates. Consumers are advised to avoid accepting summary bills and instead demand a full itemized statement to verify that no unbundled codes or services not rendered are included, ensuring the final charge aligns with the transparent cash or negotiated rates provided.