CMS Price Transparency Data

X-ray, pelvis

Facility: Central Montana Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $110
Cash Discount Price: $151
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Central Montana Medical Center is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.03x the Medicare baseline. Located in 408 Wendell Ave, Lewistown, MT.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$110

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: $151 (141%)

Insurance Median: $110 (103%)

Cash: $151 (141% of Medicare)

Ins. Median: $110 (103% 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	$8 - $288	7%
Humana	$8 - $173	7%
Triwest - All Plans	$8 - $169	7%
Veterans Affairs - All Plans	$8 - $169	7%
Allegiance Comm - All Other Plans	$14 - $307	13%
Allegiance Rbphp	$14 - $579	13%
Health Infonet - All Plans	$14 - $307	13%
Montana Health Co-Op - All Plans	$14 - $310	13%
Ebms - All Plans	$15 - $304	14%
Coventry/First Health - All Plans	$297	278%
UnitedHealthcare	$297	278%
Interwest Ppo	$313	293%
Pacific Source Hp - All Plans	$313	293%
Interwest Trad - All Other Plans	$320	300%

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 $151.
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 Central Montana 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.