CMS Price Transparency Data

X-ray, pelvis

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $292
Cash Discount Price: $399
vs. Medicare Baseline: 2.73x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $292. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $399. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.73x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$399

Average discount available for prompt cash payment at this facility.

Insurance Median

$292

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: $399 (374%)

Insurance Median: $292 (273%)

Cash: $399 (374% of Medicare)

Ins. Median: $292 (273% 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 273% of the Medicare baseline (a markup of 173%). 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
Wps Health Insurance	$91 - $283	85%
Humana	$101 - $374	95%
Managed Health Services	$101	95%
Molina Healthcare Of Wi	$101 - $357	95%
Network Health Plan	$101 - $351	95%
Quartz	$101 - $239	95%
Security Health Plan (Shp)	$101 - $243	95%
UnitedHealthcare	$101 - $588	95%
Veteran'S Administration (Va Ccn)	$101	95%
Blue Cross Blue Shield	$104 - $194	97%
Group Health Cooperative Of Eau Claire	$107 - $399	100%
Icare	$108	101%
The Alliance	$213	199%
Amish/Mennonite	$231	216%
Cigna	$286 - $311	268%
Health Payment Systems	$292	273%
First Health	$357	334%
Trilogy	$378	354%
Healtheos By Multiplan Inc.	$391 - $399	366%
Health Partners	$399	374%
Coventry	$403	377%

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 $399.
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 - Beaver Dam (Mmc-Bd) 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.