CMS Price Transparency Data

X-ray, pelvis

Facility: Community Memorial Hospital

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $347
  • Cash Discount Price: $273
  • vs. Medicare Baseline: 3.25x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Community Memorial Hospital is $347. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $273. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.25x the Medicare baseline. Located in W180 N8085 Town Hall Rd, Menomonee Falls, WI.
Cash / Self-Pay
$273

Average discount available for prompt cash payment at this facility.

Insurance Median
$347

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: $273 (256%)
Insurance Median: $347 (325%)
Cash: $273 (256% of Medicare)
Ins. Median: $347 (325% 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 325% of the Medicare baseline (a markup of 225%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $33 - $422 31%
Allwell $103 96%
Community Care $103 96%
Health Partners $103 - $322 96%
Humana $103 96%
Icare $103 96%
Network Health Plan $103 - $399 96%
Security Health Plan $103 96%
UnitedHealthcare $103 - $597 96%
Aetna $105 - $347 98%
Care Wisconsin/Mychoice $106 99%
Centivo $149 - $164 140%
Froedtert South $208 195%
Chorus Community Health Plan $213 199%
Sheboygan Employers Health Network $293 274%
Common Ground $298 279%
Trilogy $342 320%
Health Payment Systems $345 323%
Wisconsin Physician Services $347 325%
Aspirus $397 372%
Ibsi Passport $402 376%
Americas Choice $432 404%
Federated Mutual $432 404%
Healtheos $432 404%
Multiplan/Private Healthcare Systems $432 404%
Savility $432 404%
Cigna $436 408%
First Health Network $436 408%
Healthsmart $446 418%
Physicians Plus $446 418%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: W180 N8085 Town Hall Rd, Menomonee Falls, WI 53051
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals