X-ray, pelvis
Facility: Girard Medical Center
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $111
- Cash Discount Price: $190
- vs. Medicare Baseline: 1.04x 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 |
|---|---|---|
| Kansas Superior Select-All Plans | $111 | 104% |
| Blue Cross Blue Shield | $111 - $126 | 104% |
| Ambetter / Centene | $111 | 104% |
| Medicare (plans) | $111 | 104% |
| Aetna | $111 - $555 | 104% |
| UnitedHealthcare | $111 - $301 | 104% |
| Humana | $111 | 104% |
| Multiplan-All Plans | $293 | 274% |
| Uhhis-All Plans | $301 | 282% |
Consumer Guidance & Cost Commentary
For the X-ray, pelvis procedure at Girard Medical Center in Girard, KS, the facility's cash median rate is $190.00, while the median negotiated rate paid by insurance payers is $111.00. This data indicates that for patients with high-deductible plans or those without insurance, paying cash directly may be more cost-effective than relying on insurance, as the negotiated rate exceeds the cash price. However, patients should verify if their specific plan has a deductible that must be met before these negotiated rates apply, as paying the full $111.00 could result in out-of-pocket costs if the deductible has not been satisfied. Additionally, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill amount.
It is important to understand that the $111.00 median negotiated rate represents the average amount insurance companies agree to pay, which often differs from the facility's full chargemaster gross price of $317.00. While the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still request an itemized billing audit if they receive a summary bill that obscures individual charges. Since over 80% of hospital bills contain errors, reviewing the line-by-line statement can help identify unbundled codes or services not rendered. Furthermore, comparing this facility's pricing to the Medicare benchmark of $106.81 provides a clear baseline for the "true cost" of care, revealing that commercial rates are often marked up significantly above this federal standard.