X-ray, pelvis
Facility: Republic County Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $260
- Cash Discount Price: $212
- vs. Medicare Baseline: 2.43x 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 243% of the Medicare baseline (a markup of 143%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $241 | 226% |
| Aetna | $255 | 239% |
| Meritain-All Plans | $255 | 239% |
| UnitedHealthcare | $260 | 243% |
| First Health-All Plans | $269 | 252% |
| Cigna | $269 | 252% |
| Midlands Choice-All Plans | $269 | 252% |
Consumer Guidance & Cost Commentary
For this X-ray of the pelvis at Republic County Hospital in Belleville, KS, the negotiated rates for major payers like UnitedHealthcare and First Health are $260, which matches the median negotiated amount. While the facility's cash price is lower at $212, patients with high-deductible plans may find that paying cash upfront is more cost-effective than relying on insurance, as the insurer's negotiated rate of $260 exceeds the cash price. It is important to note that while the facility is a Critical Access Hospital with a voluntary non-profit ownership, the specific negotiated rates for this service remain fixed at $260 across all listed plans, including Rural Carriers and Aetna.
To ensure you are not overcharged, we recommend requesting an itemized billing audit to verify that all charges align with the CPT code 72170 and that no unbundled services or cancelled tests have been billed. Additionally, since the facility offers prompt-pay discounts for upfront cash payments, you should contact the billing department before scheduling to confirm the self-pay rate and request a waiver of insurance submission to avoid automatic claims processing. While the data does not provide specific county or state average comparisons for this procedure, understanding that commercial negotiated rates often include administrative overhead can help you evaluate whether the $260 rate is reasonable compared to the Medicare benchmark of $106.81.