CMS Price Transparency Data

X-ray, pelvis

Facility: Lafollette Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $100
  • Cash Discount Price: $250
  • vs. Medicare Baseline: 0.94x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Lafollette Medical Center is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $250. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.94x the Medicare baseline. Located in 923 East Central Avenue, La Follette, TN.
Cash / Self-Pay
$250

Average discount available for prompt cash payment at this facility.

Insurance Median
$100

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: $250 (234%)
Insurance Median: $100 (94%)
Cash: $250 (234% of Medicare)
Ins. Median: $100 (94% 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.

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 $16 - $145 15%
Bluecare $16 - $18 15%
Aetna $21 - $519 20%
Medicaid / KanCare $21 - $42 20%
UnitedHealthcare $21 - $834 20%
Wellcare $21 20%
Amerigroup $83 - $89 78%
Tricare $83 - $93 78%
Node Champva $88 - $98 82%
Humana $90 - $183 84%
Medicare (plans) $90 - $100 84%
Node Bluecare Plus Tn Mcr Adv $90 - $100 84%
Triwest $90 - $100 84%
Node Hospice Non Par Agree $91 - $102 85%
Node Va $91 - $102 85%
Node Wellcare Mcr Adv $91 - $102 85%
Node Devoted Health Mcr Adv $92 - $102 86%
Node Farm Bureau Mcr Adv $92 - $102 86%
Node Blueadvantage Mcr Adv $93 - $103 87%
Node Healthspring Mcr Adv $93 - $103 87%
Node Amerigroup Mcr Adv $94 - $105 88%
Windsor Health Plan $94 - $105 88%
Veterans Eval Services $95 89%
Node Nhc Mcr Adv $99 - $110 93%
Node Us Dept Of Labor $114 - $127 107%
Cigna $126 - $140 118%
Novanet Work Comp Tn $142 - $158 133%
Tn Work Comp $144 - $160 135%
Ambetter / Centene $169 - $188 158%
Node Point Comfort Underwriters $201 - $224 188%
Self Pay $239 224%
Multiplan Complementary $634 594%
Beech Street Work Comp Tn $14,276 - $15,862 13366%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 923 East Central Avenue, La Follette, TN 37766
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals