CMS Price Transparency Data

X-ray, pelvis

Facility: Essentia Health St Marys - Detroit Lakes

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $176
Cash Discount Price: $171
vs. Medicare Baseline: 1.65x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Essentia Health St Marys - Detroit Lakes is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $171. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.65x the Medicare baseline. Located in 1027 Washington Ave, Detroit Lakes, MN.

Cash / Self-Pay

$171

Average discount available for prompt cash payment at this facility.

Insurance Median

$176

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: $171 (160%)

Insurance Median: $176 (165%)

Cash: $171 (160% of Medicare)

Ins. Median: $176 (165% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$74 - $484	69%
Healthpartners Care Pmap	$104	97%
Itasca Med Care	$106	99%
Primewest	$106	99%
Advocare/Security Health	$112	105%
Freedom Blue Ppo	$112	105%
Healthpartners Care Msho / Mcr Adv	$112	105%
Imcare Msho Pcc Prime	$112	105%
Imcare Msho Ref Req	$112	105%
Medica Advantage Solutions	$112	105%
Medica Msho/Dual Solutions	$112	105%
Medica Prime Solution Group	$112	105%
Medicare (plans)	$112	105%
Nd Va Administration	$112	105%
Platinum Blue/Vantage Blue	$112	105%
Primewest Msho	$112	105%
Secure Blue Msho	$112	105%
Ubh Cost Plan	$112	105%
Ubh Msho	$112	105%
Ucare Msho	$112	105%
UnitedHealthcare	$112 - $224	105%
Sanford Healthplan	$115 - $188	108%
Medica Uplan	$170	159%
Ucare	$176	165%
Healthpartners	$179 - $196	168%
Medica	$186 - $207	174%
Wea	$192 - $206	180%
Cigna	$196	184%
Healthpartners Pcc Prime	$196	184%
America'S Ppo	$207	194%
Medica Choice	$213	199%
Wps	$222 - $224	208%
Aetna	$227	213%
Healtheos	$230	215%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $171.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72170.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Essentia Health St Marys - Detroit Lakes is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72170.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.