CMS Price Transparency Data

X-ray, pelvis

Facility: Medicine Lodge Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $208
  • Cash Discount Price: $219
  • vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Medicine Lodge Memorial Hospital is $208. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $219. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.95x the Medicare baseline. Located in 710 N Walnut Street, Medicine Lodge, KS.
Cash / Self-Pay
$219

Average discount available for prompt cash payment at this facility.

Insurance Median
$208

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: $219 (205%)
Insurance Median: $208 (195%)
Cash: $219 (205% of Medicare)
Ins. Median: $208 (195% 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
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.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 710 N Walnut Street, Medicine Lodge, KS 67104
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals