X-ray, pelvis
Facility: Susan B Allen Memorial Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $554
- Cash Discount Price: $304
- vs. Medicare Baseline: 5.19x 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 519% of the Medicare baseline (a markup of 419%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 328% |
| Providrs Care | $757 | 709% |
Consumer Guidance & Cost Commentary
For the X-ray, pelvis procedure at Susan B Allen Memorial Hospital in El Dorado, KS, the facility's cash median price is $304.00, which is lower than the negotiated rates of $554.00 paid by UnitedHealthcare and Providrs Care. While the facility's cash rate is significantly below the gross charge of $467.00, patients with high-deductible plans may find paying cash directly more cost-effective than relying on insurance, as the negotiated rates exceed the cash price. It is important to note that while the facility is a voluntary non-profit acute care hospital, the specific negotiated rates vary by payer, and patients should verify their plan's allowed amount before scheduling to avoid unexpected costs.
The Medicare benchmark for this service is $106.81, which serves as a baseline for evaluating the facility's pricing markup. Although the data does not provide specific county or state average comparisons for this procedure, the significant difference between the Medicare rate and the cash price highlights the potential for substantial savings through direct payment. Patients should be aware that hospitals often offer prompt-pay discounts for upfront cash payments, which can further reduce the final bill. To ensure transparency, consumers are encouraged to request an itemized bill before paying to verify that all charges are accurate and that no unnecessary services have been billed.