CMS Price Transparency Data

X-ray, pelvis

Facility: Regional Medical Center

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72170
  • Insurance Median: $870
  • Cash Discount Price: $186
  • vs. Medicare Baseline: 8.15x Medicare
The contracted insurance negotiated median rate for a X-ray, pelvis at Regional Medical Center is $870. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $186. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.15x the Medicare baseline. Located in 709 W Main Street, Manchester, IA.
Cash / Self-Pay
$186

Average discount available for prompt cash payment at this facility.

Insurance Median
$870

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: $186 (174%)
Insurance Median: $870 (815%)
Cash: $186 (174% of Medicare)
Ins. Median: $870 (815% 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 815% of the Medicare baseline (a markup of 715%). 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.

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
Medical Associates Health Plan - Tri $870 815%

Consumer Guidance & Cost Commentary

Regional Medical Center in Manchester, Iowa, offers an X-ray of the pelvis with a cash median price of $186. This facility, a government-owned Critical Access Hospital, has a negotiated rate of $870, which is significantly higher than the cash price. While the median paid amount for this service is $87, the facility's rating is 4, indicating a high level of quality. The Medicare amount for this procedure is $106.81, and the comparison to Medicare shows a rate of 8.1. Patients should note that cash payments can sometimes be cheaper than insurance negotiated rates, especially for those with high-deductible plans.

For patients considering payment options, it is important to ask the hospital about self-pay or prompt-pay discounts before scheduling the procedure. These discounts can reduce the final cost if paid in full upfront, bypassing the administrative overhead associated with insurance billing. Since the negotiated rate of $870 is substantially higher than the cash price of $186, patients with high deductibles might find that paying out-of-pocket is more economical. Always verify the exact allowed amount with the hospital before check-in to ensure you are classified correctly for self-pay rates.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 709 W Main Street, Manchester, IA 52057
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals