X-ray, pelvis
Facility: Clay County Medical Center
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $18
- Cash Discount Price: $131
- vs. Medicare Baseline: 0.17x 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 |
|---|---|---|
| Multiplan- All Plans | $8 - $231 | 7% |
| UnitedHealthcare | $10 - $231 | 9% |
| Aetna | $18 - $227 | 17% |
| Health Partners - All Plans | $18 - $231 | 17% |
| Wppa/Providrs Care- All Plans | $18 - $227 | 17% |
Consumer Guidance & Cost Commentary
For this X-ray of the pelvis at Clay County Medical Center in Clay Center, KS, the cash price is $131.00, which matches the facility's median paid amount. This cash rate is significantly lower than the negotiated rates charged to insurance plans, where the lowest allowed amount is $18.00 and the highest is $231.00 across five payers. While commercial insurance contracts often cap charges at these negotiated levels, patients with high-deductible plans may find paying the full cash price of $131.00 more cost-effective if their insurance deductible has not yet been met or if the negotiated rate exceeds the cash price. It is important to note that while the facility is a Critical Access Hospital with government local ownership, the cash rate remains the baseline for self-pay patients, and any additional charges would be subject to balance billing principles if out-of-network services are involved.
To ensure you are not overcharged, always request an itemized bill before paying, as summary bills can obscure individual code costs and potential errors. Since over 80% of hospital bills contain mistakes, such as unbundled services or charges for items not rendered, asking for a line-by-line CPT-coded statement is the most effective way to verify accuracy. Additionally, you should inquire about prompt-pay discounts, which can reduce the $131.00 cash price by 20% to 50% if paid upfront, bypassing the administrative costs associated with insurance claims. Finally, compare your facility's rates to the Medicare benchmark of $106.81; while commercial rates often run 200% to 300% of this amount, fair