X-ray, pelvis
Facility: Medicine Lodge Memorial Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $208
- Cash Discount Price: $219
- vs. Medicare Baseline: 1.95x 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 |
|---|---|---|
| Tricare | $175 | 164% |
| Humana | $199 | 186% |
| Aetna | $202 - $219 | 189% |
| Hpk-All Plans | $208 | 195% |
| UnitedHealthcare | $208 | 195% |
| Medicaid / KanCare | $219 | 205% |
Consumer Guidance & Cost Commentary
For the X-ray of the pelvis at Medicine Lodge Memorial Hospital, the cash price is $219.00, which matches the facility's gross charge and the highest negotiated rate among payers. While the median negotiated rate across all payers is $208.00, patients with high-deductible plans or those without insurance may find the cash price advantageous if their insurance allows a higher allowed amount than the cash rate. It is important to note that the facility is a Critical Access Hospital in Medicine Lodge, KS, and while specific county or state average data is not provided in this report, patients should always verify if self-pay or prompt-pay discounts are available before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative claim processing fees.
The Medicare benchmark for this service is $106.81, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $219.00 represents a 1.9x multiplier compared to the Medicare rate, reflecting the standard administrative and operational costs associated with commercial billing. Although the facility is owned by a Government Hospital District, commercial insurance plans such as Aetna and Humana have negotiated rates ranging from $199 to $219, indicating that the facility's pricing aligns closely with the maximum allowed amounts for these carriers. Consumers are advised to request an itemized bill to ensure no unbundled codes or services not rendered are included, and to dispute any balance billing that exceeds the No Surprises Act protections for in-network emergency or non-emergency care.