CMS Price Transparency Data

X-ray, pelvis

Facility: Memorial Health Care Systems

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $193
Cash Discount Price: $332
vs. Medicare Baseline: 1.81x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Memorial Health Care Systems is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $332. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.81x the Medicare baseline. Located in 300 North Columbia Ave, Seward, NE.

Cash / Self-Pay

$332

Average discount available for prompt cash payment at this facility.

Insurance Median

$193

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: $332 (311%)

Insurance Median: $193 (181%)

Cash: $332 (311% of Medicare)

Ins. Median: $193 (181% 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
Molina Mcaid-All Plans	$179	168%
Ne Total Care Mcaid-All Plans	$179	168%
UnitedHealthcare	$179 - $312	168%
Beshp Mcr Adv - All Plans	$189	177%
Blue Cross Blue Shield	$189 - $315	177%
Medica Mcare Cost	$189	177%
Medica Mcr Adv	$189	177%
Tricare	$189	177%
Wellcare Mcr Adv - All Plans	$193	181%
Phcs Ppo-All Plans	$315	295%
Ambetter / Centene	$319	299%
Medica Comm-All Other Plans	$319	299%
Medica Elevate	$319	299%
Midlands Choice-All Plans	$322	301%
Aetna	$325	304%

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 $332.
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 Memorial Health Care Systems 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.