X-ray, pelvis
Facility: Aurora Medical Center
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $336
- Cash Discount Price: $270
- vs. Medicare Baseline: 3.15x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 315% of the Medicare baseline (a markup of 215%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $200 - $446 | 187% |
| Aurora Caregiver | $240 | 225% |
| Quartz One | $245 | 229% |
| Common Ground | $249 | 233% |
| Everpointe Elite | $259 | 242% |
| Healthpartners | $266 - $405 | 249% |
| Blue Cross Blue Shield | $275 - $459 | 257% |
| Quartz Group | $290 | 272% |
| Hs Technology | $293 | 274% |
| Wisconsin Physician Service | $299 - $315 | 280% |
| Molina Exchange | $308 | 288% |
| Health Eos Plus | $324 | 303% |
| Centivo | $328 | 307% |
| UnitedHealthcare | $336 - $455 | 315% |
| Health Payment Systems | $400 | 374% |
| Trilogy | $410 | 384% |
| Health Eos | $432 | 404% |
| Cigna | $457 - $460 | 428% |
Consumer Guidance & Cost Commentary
For this X-ray service at Aurora Medical Center in Grafton, Wisconsin, the cash price of $270 is notably lower than the facility's gross charge of $540 and significantly below the state average of $270. While Medicare benchmarks this procedure at $106.81, commercial insurance plans typically pay negotiated rates ranging from $200 to $460, with most plans settling around $336 to $344. This disparity highlights that cash-paying can be a more cost-effective option for patients with high-deductible plans, as the insurance negotiated rate often exceeds the cash price.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, unexpected ancillary services or out-of-network providers could still trigger surprise costs. To minimize financial exposure, individuals should request a self-pay or prompt-pay discount of up to 50% upfront before scheduling, rather than waiting for an insurance bill to arrive. Furthermore, consumers are encouraged to demand a full itemized audit of their final statement to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through formal written disputes.