CMS Price Transparency Data

X-ray, pelvis

Facility: Lee's Summit Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $387
Cash Discount Price: $1,932
vs. Medicare Baseline: 3.62x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Lee's Summit Medical Center is $387. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,932. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.62x the Medicare baseline. Located in 2100 Se Blue Parkway, Lees Summit, MO.

Cash / Self-Pay

$1,932

Average discount available for prompt cash payment at this facility.

Insurance Median

$387

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: $1,932 (1809%)

Insurance Median: $387 (362%)

Cash: $1,932 (1809% of Medicare)

Ins. Median: $387 (362% 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 362% of the Medicare baseline (a markup of 262%). 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
Multiplan	$30 - $1,433	28%
Blue Cross Blue Shield	$31 - $833	29%
Aetna	$33 - $988	31%
Humana	$33 - $42	31%
Corvel Corporation	$36 - $1,259	34%
Oha Network	$37 - $968	35%
United	$60 - $871	56%
Healthyblue	$61	57%
Amerigroup	$62	58%
Medicaid / KanCare	$62	58%
Unicare	$62	58%
Home State Health Plan	$63	59%
Cigna	$122 - $1,549	114%
Ambetter / Centene	$359 - $360	336%
Nhc Advantage	$366 - $368	343%
Wppa Providrs Care Network	$386 - $387	361%
Universal Healthcare	$675 - $678	632%
Coventry	$775 - $778	726%
Coventry Kc Mo	$791 - $794	741%
College Park Family Care Center	$829 - $833	776%
Focus Healthcare Mgmt, Inc	$1,446 - $1,452	1354%
Cco, Inc.	$1,639 - $1,646	1535%

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 $1,932.
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 Lee's Summit 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.