X-ray, pelvis
Facility: Wamego Health Center
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $46
- Cash Discount Price: $252
- vs. Medicare Baseline: 0.43x 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 |
|---|---|---|
| Aetna | $7 - $94 | 7% |
| Medicaid / KanCare | $7 - $94 | 7% |
| UnitedHealthcare | $7 - $91 | 7% |
| Providrs Care | $11 - $35 | 10% |
| Tricare | $46 | 43% |
| Blue Cross Blue Shield | $166 - $175 | 155% |
Consumer Guidance & Cost Commentary
For the X-ray of the pelvis at Wamego Health Center, the cash median price is $252.00, which is significantly lower than the facility's gross charge of $631.00. While the facility is a Critical Access Hospital in Wamego, KS, and serves Medicaid/KanCare plans, patients should note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead. For instance, Blue Cross Blue Shield has a negotiated range of $166 to $175, which is higher than the cash rate, meaning self-pay patients might save money by paying directly. Additionally, the facility offers a median negotiated rate of $46.00, which is the lowest figure in this dataset, but this rate is contingent on specific insurance contracts and may not apply to all payers.
When comparing this service to broader benchmarks, the cash price of $252.00 is notably higher than the Medicare amount of $106.81, indicating a markup typical of commercial billing structures. However, patients should be aware of balance billing risks if they receive care from out-of-network providers, where the provider could bill the difference between their full charge and the insurance allowed amount. To avoid unexpected costs, it is advisable to request a prompt-pay discount or self-pay rate before scheduling, as these upfront payments can bypass costly insurance claims processing. Furthermore, if a bill is received, patients should demand an itemized audit to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through formal written disputes.