X-ray, pelvis
Facility: Clara Barton Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $220
- Cash Discount Price: $171
- vs. Medicare Baseline: 2.06x 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 206% of the Medicare baseline (a markup of 106%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $125 | 117% |
| 6 Degrees Health - All Plans | $171 | 160% |
| Wppa-All Plans | $195 | 183% |
| Phcs - All Plans | $220 | 206% |
| UnitedHealthcare | $220 | 206% |
| Aetna | $220 | 206% |
| Hlth Partners Of Ks-All Plans | $224 | 210% |
Consumer Guidance & Cost Commentary
For this X-ray of the pelvis at Clara Barton Hospital in Hoisington, KS, the negotiated rates range from $125 to $220 depending on your specific insurance plan, while the cash price is $171. It is important to note that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures; in this case, paying cash directly could result in a lower out-of-pocket cost than using an in-network plan if your deductible has not yet been met. Since the facility is a Critical Access Hospital, you should verify whether your specific policy offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating the cost of this service, it is more accurate to compare the negotiated rate against the Medicare benchmark rather than the hospital's gross charge. The Medicare rate for this procedure is $106.81, which serves as a scientifically validated baseline for the true cost of care. While the facility's negotiated rate of $220 is higher than the Medicare amount, this markup is standard for commercial contracts that include claims processing and utilization review. Always request an itemized bill to ensure no errors exist, as over 80% of hospital bills contain discrepancies that can be resolved through a formal audit.