X-ray, pelvis
Facility: William Newton Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $91
- Cash Discount Price: $188
- vs. Medicare Baseline: 0.85x 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 |
|---|---|---|
| Triwest- All Plans | $66 | 62% |
| Ambetter / Centene | $68 - $188 | 64% |
| Blue Cross Blue Shield | $68 - $126 | 64% |
| UnitedHealthcare | $68 - $169 | 64% |
| Providrs Care Nexus | $115 | 108% |
| Providrs Care - All Other Plans | $131 | 123% |
Consumer Guidance & Cost Commentary
For the X-ray, pelvis procedure at William Newton Hospital in Winfield, KS, the cash price is $188.00, which matches the facility's gross charge and the cash median. While the hospital is a Critical Access Hospital with a government-local ownership structure, the negotiated rates vary significantly by insurer, ranging from $66 to $188. It is important to note that for patients with high-deductible plans, paying the cash price of $188.00 upfront can sometimes be more cost-effective than relying on insurance, as the negotiated rates paid by some payers exceed the cash price. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the final amount owed by bypassing costly insurance claims processing.
This procedure's pricing is benchmarked against the Medicare rate of $106.81, which serves as the objective baseline for evaluating hospital markups. The cash price of $188.00 represents a 76% increase over the Medicare amount, illustrating the typical markup found in commercial pricing. While the data provided does not include specific state or county average comparisons for this code, the facility's ownership by the local government and its status as a Critical Access Hospital may influence its pricing strategy compared to larger regional centers. Consumers are advised to request an itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal audit dispute.