CMS Price Transparency Data

X-ray, pelvis

Facility: Mercy Hospital - Cassville

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $263
Cash Discount Price: $214
vs. Medicare Baseline: 2.46x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Mercy Hospital - Cassville is $263. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $214. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.46x the Medicare baseline. Located in 94 Main Street, Cassville, MO.

Cash / Self-Pay

$214

Average discount available for prompt cash payment at this facility.

Insurance Median

$263

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: $214 (200%)

Insurance Median: $263 (246%)

Cash: $214 (200% of Medicare)

Ins. Median: $263 (246% 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 246% of the Medicare baseline (a markup of 146%). 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
Aetna	$16 - $293	15%
Humana	$16 - $280	15%
Medicaid / KanCare	$16 - $171	15%
Medicare (plans)	$99 - $141	93%
Blue Cross Blue Shield	$100 - $319	94%
Dept Of Veteran Affairs Contracted [320106]	$112	105%
Tricare	$133	125%
Cherokee Nation Health Serv Contracted [320066]	$136	127%
Cigna	$136 - $313	127%
Cross Timbers Hospice [20098]	$136	127%
Elara Caring Aspire Hospice [20433]	$136	127%
Globalhealth Contracted [320145]	$136	127%
Halo Hcr Inc Hospice Contracted [320432]	$136	127%
Halo Hcr Inc Hospice [20432]	$136	127%
Indian Health Service Contracted [320198]	$136	127%
Kindful Hospice Contracted [320434]	$136	127%
Kindful Hospice [20434]	$136	127%
Medical Associates Health Contracted [320444]	$136	127%
Mercy Hospice Okc [20252]	$136	127%
Mercy Mgd Behavioral Health Contracted [320259]	$136	127%
Pace Of The Ozarks Contracted [320518]	$136	127%
Provider Partners Health Plans Contracted [320450]	$136	127%
Qual Choice Contracted [320325]	$136	127%
UnitedHealthcare	$136 - $313	127%
Healthscope Contracted [320182]	$138	129%
Administrative Payor Contracted [320005]	$148	139%
Centivo Contracted [320505]	$168	157%
Ambetter / Centene	$171	160%
Home State Health Plan Contracted [320187]	$171	160%
Novasys Contracted [320285]	$171	160%
Healthlink Contracted [320179]	$214 - $296	200%
Preferred Health Plan Contracted [320522]	$214	200%
Health Systems Inc Contracted [320174]	$263	246%
Insurance System Inc Contracted [320465]	$263	246%
Point C Contracted [320238]	$263 - $296	246%
Point C [20238]	$263	246%
United Medical Resources Contracted [320454]	$263 - $280	246%
Workers Comp [20426]	$263 - $296	246%
Municipal Health Plan Contracted [320271]	$266	249%
Medica Contracted [320239]	$295	276%
90 Degree Benefits Contracted [320436]	$296	277%
Aither Health Contracted [320449]	$296	277%
American Healthcare Alliance Contracted [320020]	$296	277%
Auxiant Contracted [320462]	$296	277%
Benefit Management Contracted [320052]	$296	277%
Ebms Contracted [320493]	$296	277%
Edison Health Solutions Contracted [320502]	$296	277%
Evolutions Health Care Contracted [320124]	$296	277%
Imagine 360 Contracted [320494]	$296	277%
Mercy Benefit Admin Contracted [320251]	$296	277%
Reflect Health Contracted [320492]	$296	277%
Show-Me Health Administrators Contracted [320483]	$296	277%
Usa Managed Care Org Contracted [320429]	$296	277%
Yuzu Health Contracted [320521]	$296	277%
First Health Contracted [320128]	$313	293%
Multiplan Contracted [320270]	$313	293%
Private Health Care Systems Contracted [320320]	$313	293%

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 $214.
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 Mercy Hospital - Cassville 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.