CMS Price Transparency Data

X-ray, pelvis

Facility: Marshfield Medical Center - Weston

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $269
Cash Discount Price: $301
vs. Medicare Baseline: 2.52x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at Marshfield Medical Center - Weston is $269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $301. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.52x the Medicare baseline. Located in 3400 Ministry Parkway, Weston, WI.

Cash / Self-Pay

$301

Average discount available for prompt cash payment at this facility.

Insurance Median

$269

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: $301 (282%)

Insurance Median: $269 (252%)

Cash: $301 (282% of Medicare)

Ins. Median: $269 (252% 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 252% of the Medicare baseline (a markup of 152%). 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%
UnitedHealthcare	$101 - $262	95%
Veteran'S Administration (Va Ccn)	$101	95%
Blue Cross Blue Shield	$104 - $220	97%
Group Health Cooperative Of Eau Claire	$107 - $285	100%
The Alliance	$136 - $1,574	127%
Family Health Center (Fhc)	$158	148%
Amish/Mennonite	$174	163%
Sanford Health Plan	$174	163%
Besse Forest Products	$269	252%
Molina Healthcare Of Wi	$269	252%
Rice Lake School District	$269	252%
Wps Health Insurance	$281 - $306	263%
Medica Of Wi	$295 - $302	276%
Cigna	$298	279%
Healtheos By Multiplan Inc.	$298 - $301	279%
Corvel	$301	282%
First Health	$301	282%
Health Partners	$301	282%
Three Rivers Provider Network (Trpn)	$301	282%
Trilogy	$303 - $304	284%
Coventry	$304	285%
Health Smart	$304	285%
Rising Medical Work Comp	$307	287%

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 $301.
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 - Weston 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.