CMS Price Transparency Data

X-ray, pelvis

Facility: St Luke Hospital & Living Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $130
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at St Luke Hospital & Living Center is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.22x the Medicare baseline. Located in 535 South Freeborn, Marion, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$130

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Insurance Median: $130 (122%)
Ins. Median: $130 (122% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Kansas Department Of Health And Environment $130 122%
Bluestem Pace $130 122%
Va Ccn $130 122%
Blue Cross Blue Shield $130 122%
UnitedHealthcare $130 122%
Humana $130 122%
Ambetter / Centene $131 123%

Consumer Guidance & Cost Commentary

For the X-ray of the pelvis (CPT 72170) at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate is $130, which aligns exactly with the lowest and highest rates reported across seven major payers including Blue Cross Blue Shield and Humana. This negotiated amount is significantly lower than the facility's gross charge of $255, reflecting the standard administrative overhead and contract caps that insurance plans utilize. When compared to the Medicare benchmark of $106.81, the negotiated rate represents a 1.2x markup, indicating the cost structure relative to the federal baseline. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not provide a specific cash or median paid amount, so patients cannot yet confirm if paying out-of-pocket directly would result in a lower total cost than using insurance.

Because the data indicates no specific cash or median paid values are available for this service, patients should proactively contact the billing department to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payments. It is important to note that even though insurance contracts often set a maximum allowed amount, the actual patient responsibility depends on their individual deductible and copay status; if a patient has a high deductible, paying the cash price directly might be more affordable than the insurance negotiated rate. To ensure the most accurate pricing, patients should request an itemized bill before scheduling any appointments to verify that all charges are correct and to identify any potential errors or unbundled codes that could be disputed.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 535 South Freeborn, Marion, KS 66861
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals