X-ray, pelvis
Facility: Mitchell County Hospital Health Systems
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $221
- Cash Discount Price: $210
- vs. Medicare Baseline: 2.07x 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 207% of the Medicare baseline (a markup of 107%). 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 |
|---|---|---|
| UnitedHealthcare | $107 - $233 | 100% |
| Blue Cross Blue Shield | $126 | 118% |
| Triwest Well Mark All Plans | $198 | 185% |
| Aetna | $210 | 197% |
| First Health-All Plans | $210 | 197% |
| Pref Hlth Care Sytms Comm - All Plans | $210 | 197% |
| Phc Leased Ntwrk Access - All Plans | $221 | 207% |
| Auxiant-All Plans | $221 | 207% |
| Multiplan Ppo - All Plans | $221 | 207% |
| Health Partners Ks-All Plans | $231 | 216% |
| Cigna | $231 | 216% |
Consumer Guidance & Cost Commentary
For the X-ray, pelvis procedure (CPT 72170) at Mitchell County Hospital Health Systems in Beloit, KS, the facility's cash price of $210.00 is notably lower than the average negotiated rate of $221.00 paid by commercial insurers. While the facility is a Critical Access Hospital with government-local ownership, patients should be aware that insurance contracts often include administrative overhead that inflates the baseline price by 20% to 40% compared to direct cash payments. If you have a high-deductible plan, paying the cash price upfront may result in lower out-of-pocket costs than your insurance allowing, as the negotiated ceiling rate frequently exceeds the cash price. Additionally, the facility offers a prompt-pay discount for patients who settle their bill in full within 30 days, which can further reduce the final amount owed by bypassing costly claims processing fees.
When evaluating this price against benchmarks, the facility's cash rate of $210.00 is significantly lower than the Medicare amount of $106.81, indicating a markup relative to the federal government's fixed reimbursement rate. However, it is important to note that commercial negotiated rates often average 200% to 300% of Medicare, whereas fair pricing is typically defined as 120% to 150% of Medicare. To ensure you are receiving the best possible rate, we recommend requesting an itemized billing audit to verify that no services were unbundled or double-charged, as over 80% of hospital bills contain errors. Finally, if you are concerned about balance billing, remember that the No Surprises Act protects you from