X-ray, pelvis
Facility: Oakleaf Surgical Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $104
- Cash Discount Price: $309
- vs. Medicare Baseline: 0.97x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
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 | $104 | 97% |
| Dean Health Plan | $104 | 97% |
| Group Health Cooperative Of Eau Claire | $104 | 97% |
| Healthpartners | $104 | 97% |
| Humana | $104 | 97% |
| Medica | $104 | 97% |
| Quartz Health Solutions | $104 | 97% |
| Security Health Plan Of Wi | $104 - $876 | 97% |
| Ucare Wi | $104 | 97% |
| UnitedHealthcare | $104 | 97% |
| Alliance | $259 | 242% |
Consumer Guidance & Cost Commentary
For the CPT code 72170 (X-ray, pelvis) at Oakleaf Surgical Hospital in Altoona, WI, the cash median rate is $309. This facility is owned by physicians, and while the gross charge listed is $343, the median negotiated rate for in-network payers is $104, with the median paid amount being $277. Medicare benchmarks this service at $106.81, which serves as the objective baseline for evaluating pricing markups. It is important to note that commercial negotiated rates often average 200% to 300% of Medicare, whereas fair pricing is typically defined as 120% to 150% of the Medicare rate.
Patients should be aware that cash-pay options can sometimes be more cost-effective than insurance, particularly for those with high-deductible plans where the insurance negotiated rate might exceed the cash price. Although the facility does not list a specific county or state average in the provided data, patients are encouraged to verify their deductible status before scheduling, as some in-network facilities may charge significantly higher rates than others. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing the administrative costs and delays associated with insurance claims processing.