CMS Price Transparency Data

X-ray, pelvis

Facility: Ellsworth County Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $143
  • Cash Discount Price: $159
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Ellsworth County Medical Center is $143. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $159. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.34x the Medicare baseline. Located in 1604 Aylward Avenue, Ellsworth, KS.
Cash / Self-Pay
$159

Average discount available for prompt cash payment at this facility.

Insurance Median
$143

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $159 (149%)
Insurance Median: $143 (134%)
Cash: $159 (149% of Medicare)
Ins. Median: $143 (134% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Triwest -All Plans $75 70%
Healthy Blue Mcr Adv $75 70%
Humana $75 - $151 70%
Va Ccn-All Plans $75 70%
UnitedHealthcare $103 - $159 96%
Blue Cross Blue Shield $119 - $125 111%
First Health - All Plans $143 134%
Aetna $143 134%
Cigna $151 141%
Healthy Blue Mcaid- All Other Plans $159 149%
Coventry Mcaid-All Plans $159 149%
Medicaid / KanCare $159 149%
Providers Care-Wppa-All Plans $238 223%

Consumer Guidance & Cost Commentary

For the X-ray of the pelvis at Ellsworth County Medical Center, the cash price is $159.00, which matches the facility's negotiated rate with several payers and the cash median. This specific service is priced at 130% of the Medicare benchmark of $106.81, indicating a markup consistent with commercial pricing structures where negotiated rates often exceed the federal baseline. While the facility is located in Ellsworth, Kansas, the provided data does not include specific county or state average comparisons for this procedure, so the $159.00 cash price serves as the primary reference point for self-pay patients.

Patients with high-deductible plans may find that paying the full cash price of $159.00 upfront is more cost-effective than relying on insurance, as the negotiated rates for some payers, such as UnitedHealthcare and Blue Cross Blue Shield, range from $103.00 to $159.00 depending on the plan. To minimize costs, individuals should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these programs can offer significant reductions for upfront payment. Additionally, if a patient receives an itemized bill, they should verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1604 Aylward Avenue, Ellsworth, KS 67439
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals