X-ray, pelvis
Facility: Hiawatha Community Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $535
- Cash Discount Price: $687
- vs. Medicare Baseline: 5.01x 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 501% of the Medicare baseline (a markup of 401%). 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 | $120 - $126 | 112% |
| UnitedHealthcare | $254 - $590 | 238% |
| Aetna | $254 - $555 | 238% |
| Humana | $257 | 241% |
| Ambetter / Centene | $305 | 286% |
| Centrus Health Direct - All Plans | $515 | 482% |
| Oscar - All Plans | $515 | 482% |
| Preferred Hlth - All Plans | $618 | 579% |
| Wppa Providrs Care - All Plans | $653 | 611% |
| Cigna | $653 | 611% |
| Midlands Choice - All Plans | $666 | 624% |
| Multiplan - All Plans | $666 | 624% |
| Healthy Blue Mcaid - All Plans | $687 | 643% |
Consumer Guidance & Cost Commentary
For the X-ray of the pelvis at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $687.00, which matches the facility's gross charge and the median amount paid by patients paying out-of-pocket. This cash rate is significantly higher than the state average for this service, indicating that commercial insurance rates are likely inflated relative to the local market. While the facility offers a "prompt-pay" discount for upfront payment, patients should be aware that insurance negotiated rates can sometimes exceed the cash price; for instance, UnitedHealthcare and Aetna have negotiated ranges starting at $254 but extending up to $590 and $555 respectively, which may result in higher out-of-pocket costs for members with high deductibles who have not yet met their plan thresholds.
The facility's billing practices align with standard commercial insurance dynamics where negotiated rates often include administrative overhead, resulting in prices that can be 200% to 300% of the Medicare benchmark of $106.81 for this procedure. Although the median negotiated rate across all payers is $535.00, which is lower than the cash price, patients must carefully review their specific plan's deductible status before assuming insurance will reduce their financial burden. To avoid unexpected balance billing or errors, consumers should request a full itemized bill before paying and verify that all services rendered are accurately coded, as over 80% of hospital bills contain discrepancies that can be resolved through a formal written audit dispute.