CMS Price Transparency Data

X-ray, pelvis

Facility: Marshfield Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $317
Cash Discount Price: $354
vs. Medicare Baseline: 2.97x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Marshfield Medical Center is $317. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $354. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.97x the Medicare baseline. Located in 611 St Joseph Ave, Marshfield, WI.

Cash / Self-Pay

$354

Average discount available for prompt cash payment at this facility.

Insurance Median

$317

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: $354 (331%)

Insurance Median: $317 (297%)

Cash: $354 (331% of Medicare)

Ins. Median: $317 (297% 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 297% of the Medicare baseline (a markup of 197%). 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
Security Health Plan (Shp)	$101 - $140	95%
Veteran'S Administration (Va Ccn)	$101	95%
Blue Cross Blue Shield	$104 - $220	97%
Group Health Cooperative Of Eau Claire	$107 - $343	100%
Family Health Center (Fhc)	$186	174%
Amish/Mennonite	$205	192%
Sanford Health Plan	$205	192%
The Alliance	$259 - $311	242%
Besse Forest Products	$317	297%
Molina Healthcare Of Wi	$317	297%
Rice Lake School District	$317	297%
Wps Health Insurance	$329 - $360	308%
Trilogy	$336 - $358	315%
Medica Of Wi	$346 - $353	324%
Cigna	$351	329%
Healtheos By Multiplan Inc.	$351 - $354	329%
Corvel	$354	331%
First Health	$354	331%
Health Partners	$354	331%
Three Rivers Provider Network (Trpn)	$354	331%
Coventry	$358	335%
Health Smart	$358	335%
Rising Medical Work Comp	$362	339%
UnitedHealthcare	$585	548%

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 $354.
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 Marshfield 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.