CMS Price Transparency Data

X-ray, pelvis

Facility: New Ulm Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $237
Cash Discount Price: $190
vs. Medicare Baseline: 2.22x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at New Ulm Medical Center is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.22x the Medicare baseline. Located in 1324 Fifth North Street, New Ulm, MN.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$237

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: $190 (178%)

Insurance Median: $237 (222%)

Cash: $190 (178% of Medicare)

Ins. Median: $237 (222% 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 222% of the Medicare baseline (a markup of 122%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$56 - $449	52%
Ucare Pmap (A B C D E G N O S U R H)	$58 - $93	54%
Medica Health System	$64 - $262	60%
Health Partners	$97 - $244	91%
Medicaid / KanCare	$100 - $221	94%
Aetna	$102 - $393	95%
Medicare (plans)	$108 - $204	101%
Medica	$113 - $240	106%
Hennepin Health	$114	107%
UnitedHealthcare	$125 - $325	117%
South Country Health Alliance	$152 - $239	142%
Medica Dual Solutions (A U)	$180	169%
Americas Ppo (Araz)(A M U)	$193 - $290	181%
Medica Ubh (A)	$202 - $364	189%
Medica Ubh (N)	$215 - $386	201%
Medica Ubh Pmap	$231 - $368	216%
Americas Ppo (Araz)(B D N O R S V)	$237 - $355	222%
First Health (A C E G H U B D N O R S)	$242 - $386	227%
Medica Mhps	$249	233%
Cigna	$251 - $376	235%
Americas Ppo (Araz) (B D N H O R S)	$258 - $386	242%
All Other Contracted Care (A B C D E G H N O R S U)	$307 - $460	287%
Bc Aware/Blue Plus (Nr)	$311	291%

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 $190.
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 New Ulm Medical Center 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.