X-ray, pelvis
Facility: Sheridan County Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $183
- Cash Discount Price: $235
- vs. Medicare Baseline: 1.71x 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 |
|---|---|---|
| Celtic Insurance | $142 | 133% |
| Blue Cross Blue Shield | $183 | 171% |
| UnitedHealthcare | $223 | 209% |
Consumer Guidance & Cost Commentary
For the X-ray of the pelvis at Sheridan County Hospital in Hoxie, Kansas, the cash price is $235.00, which matches the facility's listed gross charge. This rate is significantly higher than the Medicare benchmark of $106.81, reflecting a markup of 170% above the federal baseline. While commercial insurance plans like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare have negotiated rates of $142, $183, and $223 respectively, these amounts remain above the cash price for this specific service. Patients with high-deductible plans may find that paying the cash price directly is more cost-effective than using insurance, as the negotiated rates exceed the out-of-pocket cash amount. Additionally, patients should inquire about self-pay or prompt-pay discounts, which can further reduce the final bill if paid in full upfront.
This facility, a Critical Access Hospital owned by the local government, does not have a publicly available facility rating or historical average payment data to compare against. However, the absence of a median paid value suggests that commercial claims data for this specific code is not yet available in the current reporting period. To ensure you are receiving the best possible rate, it is advisable to request an itemized bill before scheduling any procedures. This allows you to verify that no unbundled codes or services not rendered are included in the total. If you receive a balance bill from an out-of-network provider, such as an emergency physician or lab, you may be eligible for protections under the No Surprises Act, which prevents surprise billing for non-emergency services at in-network facilities. Always confirm your deductible status and ask for a waiver of insurance submission if you