X-ray, pelvis
Facility: Trego County Lemke Memorial Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $173
- Cash Discount Price: $179
- vs. Medicare Baseline: 1.62x 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 | $103 | 96% |
| Tricare | $111 | 104% |
| UnitedHealthcare | $130 - $210 | 122% |
| Aetna | $130 - $189 | 122% |
| Va Ccn - All Plans | $130 | 122% |
| Medicaid / KanCare | $130 - $210 | 122% |
| Ambetter / Centene | $143 | 134% |
| Blue Cross Blue Shield | $173 | 162% |
| Health Partners - All Plans | $200 | 187% |
| Healthy Blue Mcaid - All Plans | $210 | 197% |
Consumer Guidance & Cost Commentary
For the X-ray of the pelvis at Trego County Lemke Memorial Hospital, the cash price of $179 is lower than the facility's negotiated rates with most major insurers, which range from $130 to $210 depending on the plan. While the cash price is slightly below the state average of $180, it remains higher than the Medicare benchmark of $106.81, indicating a markup of 160% over the federal rate. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance negotiated rates often exceed this amount before deductibles are met. To secure the lowest possible cost, individuals should verify their specific plan's allowed amount and ask the hospital about self-pay or prompt-pay discounts, which can further reduce the bill by 20% to 50% if paid in full upfront.
This facility, a Critical Access Hospital in Wakeeney, KS, has a single payer plan for each of the ten insurance carriers listed, with the lowest negotiated rate being $130 for UnitedHealthcare, Aetna, and Medicaid/KanCare plans. It is important to note that while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, unexpected charges can still occur from out-of-network ancillary services like emergency physicians or labs. If a patient receives an itemized bill that appears inflated or contains errors, they should request a full line-by-line audit rather than accepting a summary invoice, as over 80% of hospital bills contain mistakes such as unbundled codes or services not rendered. Disputing these errors in writing with the billing supervisor is the most