X-ray, pelvis
Facility: Memorial Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $324
- Cash Discount Price: $589
- vs. Medicare Baseline: 3.03x 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 303% of the Medicare baseline (a markup of 203%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $134 | 125% |
| Tricare | $294 | 275% |
| Humana | $294 | 275% |
| Medicare (plans) | $297 | 278% |
| Ambetter / Centene | $324 | 303% |
| Coventry - All Other Plans | $530 | 496% |
| Health Partners Of Kansas - All Plans | $559 | 523% |
| Preferred Healthcare-All Plans | $559 | 523% |
| Wppa/Providers Care-All Plans | $824 | 771% |
Consumer Guidance & Cost Commentary
For the X-ray, pelvis procedure (CPT 72170) at Memorial Hospital in Abilene, KS, the cash price is $589.00, which matches the facility's median negotiated rate of $324.00 for in-network payers like Blue Cross Blue Shield and Tricare. While the facility is a Critical Access Hospital with a government ownership structure, the cash price is significantly higher than the Medicare benchmark of $106.81, reflecting a markup common in commercial billing. It is important to note that for patients with high-deductible plans, paying the cash price of $589.00 upfront may be more cost-effective than relying on insurance, as the negotiated rate of $324.00 often exceeds the cash price once deductibles and copays are factored in. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full before or shortly after the service.
This facility's pricing data is based on a 2026-06 vintage and includes nine distinct payers, with rates ranging from $134 for Blue Cross Blue Shield to $824 for Wppa/Providers Care. The median negotiated amount of $324.00 represents the average amount commercial insurers agreed to pay, which is lower than the gross charge of $589.00 but still substantially higher than the Medicare rate. Because Medicare rates serve as the federal baseline for cost, the commercial rates here are well above the 120% to 150% fair