X-ray, pelvis
Facility: Stevens County Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $185
- Cash Discount Price: $212
- vs. Medicare Baseline: 1.73x 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 |
|---|---|---|
| Humana | $79 | 74% |
| Aetna | $81 - $212 | 76% |
| Blue Cross Blue Shield | $120 - $126 | 112% |
| First Health - All Plans | $191 | 179% |
| Wppa - All Plans | $202 | 189% |
| Medicaid / KanCare | $212 | 198% |
Consumer Guidance & Cost Commentary
For this X-ray of the pelvis at Stevens County Hospital in Hugoton, Kansas, the cash price is $212.00, which matches the facility's gross chargemaster rate. While the hospital is a Critical Access Hospital with a government-local ownership structure, the negotiated rates for major payers like Aetna and Blue Cross Blue Shield range from $81 to $212, reflecting the administrative costs and contract dynamics inherent in insurance billing. It is important to note that for patients with high-deductible plans, paying the cash price of $212.00 upfront may be more cost-effective than relying on insurance, as the negotiated allowed amounts for some carriers can exceed the cash rate. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final bill by bypassing the costly claims processing cycle.
The Medicare benchmark for this service is $106.81, which serves as a scientifically validated baseline for the true cost of care delivery. Commercial negotiated rates often average between 200% and 300% of this Medicare amount, though fair pricing is typically defined as 120% to 150% of the Medicare rate. In this specific case, the cash price of $212.00 is 1.7 times the Medicare amount, indicating a markup that is higher than the typical fair pricing range. Consumers should be aware that summary bills often obscure individual line items, so requesting a full itemized audit is the most effective way to identify errors, unbundled codes, or services not rendered. If a patient receives a balance bill