CMS Price Transparency Data

X-ray, pelvis

Facility: Bob Wilson Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $228
  • Cash Discount Price: $112
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Bob Wilson Memorial Hospital is $228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.13x the Medicare baseline. Located in 415 N Main Street, Ulysses, KS.
Cash / Self-Pay
$112

Average discount available for prompt cash payment at this facility.

Insurance Median
$228

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $112 (105%)
Insurance Median: $228 (213%)
Cash: $112 (105% of Medicare)
Ins. Median: $228 (213% of 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 213% of the Medicare baseline (a markup of 113%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 Health $89 83%
Medicare (plans) $89 83%
UnitedHealthcare $89 - $233 83%
Aetna $89 - $224 83%
Humana $89 83%
Centura Employee Plan $91 85%
Blue Cross Blue Shield $169 158%
Multiplan $252 - $260 236%
Health Partners Of Kansas $263 246%
Wppa $265 248%

Consumer Guidance & Cost Commentary

For the CPT code 72170 (X-ray, pelvis) at Bob Wilson Memorial Hospital in Ulysses, KS, the cash median price is $112.00, while the median negotiated rate across ten payers is $228.00. This facility, a voluntary non-profit Critical Access Hospital, offers a cash price that is significantly lower than the commercial negotiated rates, which range from $89 to $265 depending on the insurer. For patients with high-deductible plans, paying the cash price of $112.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that while Medicare sets a benchmark of $106.81 for this service, commercial contracts frequently result in higher out-of-pocket costs for members who have not yet met their deductibles.

To ensure you are receiving the most accurate pricing, always request an itemized bill before finalizing payment, as summary bills can obscure individual charges and potential errors. If you choose to use insurance, verify your deductible status beforehand, as the facility's negotiated rates are designed to cover administrative costs and claims processing, which can inflate the baseline price. Additionally, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final amount owed by 20% to 50% if settled in full within a short window. Since balance billing protections apply to emergency care and non-emergency services at in-network facilities, you should dispute any unexpected charges that exceed the allowed amount rather than paying immediately.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 415 N Main Street, Ulysses, KS 67880
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals