X-ray, pelvis
Facility: Lindsborg Community Hospital
Billing Code: 72170 (CPT)
- CPT Billing Code: 72170
- Insurance Median: $538
- Cash Discount Price: $412
- vs. Medicare Baseline: 5.04x 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 504% of the Medicare baseline (a markup of 404%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $125 | 117% |
| Tricare | $277 | 259% |
| Coventry Mcr Adv | $279 | 261% |
| Cigna | $500 | 468% |
| Coventry Comm-All Other Plans | $530 | 496% |
| UnitedHealthcare | $530 | 496% |
| Phcs Preferred-All Plans | $547 | 512% |
| Multiplan-All Plans | $547 | 512% |
| Century Health-All Plans | $559 | 523% |
| Wppa-All Plans | $559 | 523% |
| Health Partners -All Plans | $559 | 523% |
| Coventry Wc | $559 | 523% |
Consumer Guidance & Cost Commentary
For the X-ray, pelvis procedure at Lindsborg Community Hospital, the facility's cash price of $412.00 is lower than the median negotiated rate of $547.00 paid by most insurance plans, including Blue Cross Blue Shield and Tricare. This price difference highlights a common billing dynamic where commercial insurance contracts often result in higher out-of-pocket costs for patients compared to self-pay options, particularly for those with high-deductible plans. While the facility is a Critical Access Hospital in Kansas with a voluntary non-profit ownership structure, patients should verify their specific plan details, as some commercial payers may negotiate rates that exceed the cash price, making upfront payment the most economical choice.
Although the data does not provide specific county or state average comparisons for this service, the facility's pricing structure demonstrates the impact of administrative overhead on commercial billing. The gross charge of $589.00 serves as the baseline list price, but the significant gap between the cash rate and the median negotiated amount of $547.00 suggests that commercial contracts include administrative costs and risk premiums that do not apply to cash payers. Consumers are encouraged to explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final bill by bypassing the standard insurance claims processing cycle.