CMS Price Transparency Data

X-ray, pelvis

Facility: Essentia Health Moose Lake

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $203
  • Cash Discount Price: $228
  • vs. Medicare Baseline: 1.90x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Essentia Health Moose Lake is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.90x the Medicare baseline. Located in 4572 County Road 61, Moose Lake, MN.
Cash / Self-Pay
$228

Average discount available for prompt cash payment at this facility.

Insurance Median
$203

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: $228 (213%)
Insurance Median: $203 (190%)
Cash: $228 (213% of Medicare)
Ins. Median: $203 (190% 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.

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 $72 - $381 67%
Blue Plus Pmap Pcc Prime $72 - $169 67%
Itasca Med Care $106 99%
Primewest $106 99%
Medica Access $123 - $192 115%
Healthpartners Care Pmap $124 116%
Sanford Healthplan $132 - $139 124%
Advocare/Security Health $145 136%
Freedom Blue Ppo $145 136%
Healthpartners Care Msho / Mcr Adv $145 136%
Imcare Msho Pcc Prime $145 136%
Imcare Msho Ref Req $145 136%
Medica Advantage Solutions $145 136%
Medica Msho/Dual Solutions $145 136%
Medica Prime Solution Group $145 136%
Medicare (plans) $145 136%
Nd Va Administration $145 136%
Platinum Blue/Vantage Blue $145 136%
Primewest Msho $145 136%
Secure Blue Msho $145 136%
Ubh Cost Plan $145 136%
Ubh Msho $145 136%
Ucare Msho $145 136%
UnitedHealthcare $145 - $279 136%
Ucare $203 190%
Healthpartners $216 - $245 202%
Medica $220 - $245 206%
Medica Uplan $220 206%
Wea $222 - $237 208%
America'S Ppo $239 224%
Cigna $240 - $245 225%
Healthpartners Pcc Prime $240 - $245 225%
Medica Choice $252 236%
Wps $256 - $259 240%
Aetna $262 245%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4572 County Road 61, Moose Lake, MN 55767
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals