X-ray, pelvis
Facility: Graham County Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $143
- Cash Discount Price: $170
- vs. Medicare Baseline: 1.34x 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 | $125 | 117% |
| Medicare (plans) | $128 | 120% |
| UnitedHealthcare | $136 - $162 | 127% |
| Celtic Commercial-All Other Plans | $140 | 131% |
| Medicaid / KanCare | $145 | 136% |
| Wppa (Providers Care)-All Plans | $162 | 152% |
Consumer Guidance & Cost Commentary
For the X-ray of the pelvis at Graham County Hospital in Hill City, Kansas, the cash median price is $170.00, which matches the facility's gross charge. While Medicare sets a benchmark rate of $106.81 for this service, commercial insurance plans negotiate rates that vary significantly; for instance, UnitedHealthcare's range spans from $136 to $162 across three plans, while Medicaid/KanCare and Celtic Commercial plans both pay $145 and $140 respectively. Although the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans might find the cash price of $170.00 more affordable than their specific insurance negotiated rate, which could exceed the cash amount depending on the payer. It is important to note that while the facility's cash rate is fixed, commercial payers often include administrative overhead in their negotiated ceilings, which can inflate the final allowed amount compared to the direct cash cost.
Before scheduling any visit, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing costly insurance billing cycles. Since the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should verify their plan's allowed amount before receiving care to avoid unexpected costs. If a discrepancy arises between the billed amount and the expected rate, consumers are encouraged to request a formal, itemized billing audit to identify errors such as unbundled codes or services not rendered, as over 80% of hospital bills contain inaccuracies that can be