X-ray, pelvis
Facility: Stafford County Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $218
- Cash Discount Price: $218
- vs. Medicare Baseline: 2.04x 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 204% of the Medicare baseline (a markup of 104%). 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 |
|---|---|---|
| Health Partners-All Plans | $207 | 194% |
| Humana | $218 | 204% |
| Medica Mcr- All Plans | $218 | 204% |
| UnitedHealthcare | $218 | 204% |
| Va Ccn-All Plans | $218 | 204% |
Consumer Guidance & Cost Commentary
For the X-ray of the pelvis at Stafford County Hospital, the cash price is $218.00, which matches the median negotiated rate across all five major payers, including Health Partners, Humana, and UnitedHealthcare. This facility, a Critical Access Hospital in Stafford, KS, charges the same amount regardless of insurance status, meaning patients with high-deductible plans might save money by paying cash directly rather than using insurance. While the facility is government-owned locally, the lack of variation between cash and negotiated rates suggests there is no significant markup for in-network members, though patients should still verify if "self-pay" or "prompt-pay" discounts are available before scheduling to ensure they are receiving the lowest possible rate.
The Medicare benchmark for this service is $106.81, indicating that the commercial rate of $218.00 is approximately 204% of the Medicare amount. This aligns with the typical commercial pricing range of 200% to 300% of Medicare, reflecting the administrative costs and contract structures inherent in insurance billing. Because the cash price is already equal to the negotiated rate, there is no opportunity to reduce costs by switching payers or seeking alternative network options for this specific procedure. Patients should review their itemized bill carefully to ensure no unbundled charges or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.