CMS Price Transparency Data

X-ray, pelvis

Facility: Kiowa District Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $235
  • Cash Discount Price: $199
  • vs. Medicare Baseline: 2.20x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Kiowa District Hospital is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $199. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.20x the Medicare baseline. Located in 1002 South 4Th Street, Kiowa, KS.
Cash / Self-Pay
$199

Average discount available for prompt cash payment at this facility.

Insurance Median
$235

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: $199 (186%)
Insurance Median: $235 (220%)
Cash: $199 (186% of Medicare)
Ins. Median: $235 (220% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 220% of the Medicare baseline (a markup of 120%). 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.

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
Tricare $97 91%
Blue Cross Blue Shield $125 117%
UnitedHealthcare $199 - $249 186%
Health Partners Of Ks-All Plans $219 205%
Healthchoice-All Plans $224 210%
Humana $225 211%
Gbs Insurance - All Plans $234 219%
Multiplan-All Plans $234 219%
Aetna $237 222%
Triwest-All Plans $237 222%
Medicare (plans) $237 222%
Medicaid / KanCare $249 233%
Providers Care (Wppa)-All Plans $374 350%
Liberty Healthshare-All Plans $402 376%

Consumer Guidance & Cost Commentary

For the X-ray of the pelvis at Kiowa District Hospital in Kiowa, KS, the cash median price is $199.00, which is lower than the negotiated rates paid by most insurance plans ranging from $219 to $402. While the facility's negotiated rate of $235.00 is higher than the cash price, patients with high-deductible plans might find paying cash directly more cost-effective if their insurance allowed amount exceeds the cash rate. It is important to note that this facility is a Critical Access Hospital owned by a Government Hospital District, and the gross charge listed is $249.00. Consumers should verify their specific plan's allowed amount before scheduling, as some commercial payers may negotiate rates that differ significantly from the facility's standard negotiated rate.

To ensure you are receiving the most accurate pricing, always request an itemized bill before paying, as summary bills can obscure individual charges or unbundled codes. If you receive a large bill, do not accept a verbal dispute; instead, send a formal written audit request to the billing supervisor to identify errors or services not rendered. Additionally, ask the hospital about prompt-pay discounts, which can reduce your bill by 20% to 50% if you pay in full upfront, bypassing the administrative costs associated with insurance claims processing. While Medicare serves as a benchmark for fair pricing, the specific rates for this procedure vary by payer, so comparing your plan's allowed amount against the cash price is the most effective way to minimize out-of-pocket costs.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1002 South 4Th Street, Kiowa, KS 67070
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals