X-ray, pelvis
Facility: Stanton County Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $265
- Cash Discount Price: $278
- vs. Medicare Baseline: 2.48x 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 248% of the Medicare baseline (a markup of 148%). 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 - $264 | 112% |
| Healthy Blue Mcr Adv - All Other Plans | $273 | 256% |
| Healthy Blue Mcaid | $278 | 260% |
Consumer Guidance & Cost Commentary
For the CPT code 72170 (X-ray, pelvis) at Stanton County Hospital in Johnson, KS, the cash price is $278.00, which matches the facility's gross charge and the median negotiated rate for most payers. While the Medicare benchmark for this service is $106.81, commercial insurance plans typically negotiate rates between $120.00 and $278.00, with Blue Cross Blue Shield plans averaging between $120.00 and $264.00. Because the cash price of $278.00 is significantly higher than the Medicare rate, patients with high-deductible plans might find it beneficial to pay out-of-pocket directly, especially if their insurance negotiated rate exceeds the cash price. It is important to note that the facility is a Critical Access Hospital with government-local ownership, and patients should verify their specific plan's allowed amount before scheduling to avoid unexpected costs.
Patients should be aware that insurance companies often pay less than the full negotiated rate, resulting in a balance bill for the difference between the allowed amount and the actual charge. For this service, the median amount paid by insurers is $269.00, which is slightly lower than the cash price, meaning patients with active coverage may not save money by using insurance. To minimize costs, patients should ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, since over 80% of hospital bills contain errors, patients should request a detailed, itemized statement to review every charge and dispute any