X-ray, pelvis
Facility: Nemaha Valley Community Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $160
- Cash Discount Price: $286
- vs. Medicare Baseline: 1.50x 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 |
|---|---|---|
| Blue Cross Blue Shield | $133 | 125% |
| Humana | $140 | 131% |
| Va Ccn - All Plans | $140 | 131% |
| Aetna | $141 - $270 | 132% |
| Celtic Comm Exch - All Plans | $154 | 144% |
| Partners Direct Health - All Plans | $165 | 154% |
| Multiplan - All Plans | $286 | 268% |
| Midlands Choice - All Plans | $302 | 283% |
| Health Partners - All Plans | $302 | 283% |
Consumer Guidance & Cost Commentary
For the X-ray, pelvis procedure (CPT 72170) at Nemaha Valley Community Hospital in Seneca, KS, the cash price of $286.00 is notably higher than the facility's median negotiated rate of $160.00 and the median paid amount of $165.00. While the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, patients with high-deductible plans may find that paying cash upfront could be more cost-effective than relying on insurance, as the negotiated rates paid by payers like Aetna and Celtic Comm Exch range from $140 to $286, often exceeding the cash price. It is important to note that the gross charge of $318.00 represents the full list price before any discounts, and commercial rates are significantly higher than the Medicare benchmark of $106.81, which serves as the federal baseline for cost evaluation.
To minimize out-of-pocket expenses, patients should actively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50% by bypassing administrative claim processing fees. Since over 80% of hospital bills contain errors, consumers are advised to demand a detailed, itemized CPT-coded statement rather than accepting a summary bill, ensuring no unbundled codes or services not rendered are included. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify your specific plan's deductible status and network tiering, as some in-network providers may still charge higher rates than others depending