X-ray, pelvis
Facility: F W Huston Medical Center
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $295
- Cash Discount Price: $306
- vs. Medicare Baseline: 2.76x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 276% of the Medicare baseline (a markup of 176%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $126 | 118% |
| Aetna | $287 | 269% |
| Humana | $303 | 284% |
| Cigna | $326 | 305% |
Consumer Guidance & Cost Commentary
For the X-ray, pelvis procedure (CPT 72170) at F W Huston Medical Center in Winchester, KS, the facility's negotiated rates range from $126 to $326 depending on the insurance carrier, with a median negotiated payment of $303. This rate is significantly higher than the Medicare benchmark of $106.81, reflecting the typical administrative and contract markup found in commercial billing. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that their specific insurance plan's negotiated rate may vary; for instance, Blue Cross Blue Shield pays $126, whereas Cigna pays $326 for the same service. Because commercial rates often exceed cash prices due to multi-layered administrative costs, patients with high-deductible plans might find it financially advantageous to pay the cash median of $306 directly, provided their insurance allowed amount does not exceed this figure.
To minimize out-of-pocket costs, it is essential to verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can bypass costly insurance billing cycles and administrative overhead. Although the data does not provide a specific county or state average for comparison, understanding that the facility's gross charge of $383 is the starting point helps clarify that the final billed amount is subject to significant negotiation. Patients should request an itemized billing audit to ensure no errors exist, such as unbundled codes or services not rendered, which can inflate the total bill. Furthermore, if you are concerned about balance billing, remember that the No Surprises Act protects you from unexpected charges for out-of-network providers at in