CMS Price Transparency Data

X-ray, lower back

Facility: Adventist Health St Helena

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $441
  • Cash Discount Price: $163
  • vs. Medicare Baseline: 4.13x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Adventist Health St Helena is $441. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $163. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.13x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.
Cash / Self-Pay
$163

Average discount available for prompt cash payment at this facility.

Insurance Median
$441

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: $163 (153%)
Insurance Median: $441 (413%)
Cash: $163 (153% of Medicare)
Ins. Median: $441 (413% 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 413% of the Medicare baseline (a markup of 313%). 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
Blue Shield Bh Mcr Adv $14 - $139 13%
Blue Shield Mcr Adv $14 - $139 13%
Kaiser Mcr Adv $14 - $139 13%
Tricare $14 - $139 13%
Ah Employee Health Plan - All Plans $15 - $250 14%
Cigna $16 - $1,657 15%
Interplan-All Plans $17 - $1,346 16%
Kaiser-All Other Plans $17 - $1,698 16%
Western Growers-All Plans $21 - $1,098 20%
Blue Shield Epn-All Other Plans $22 - $975 21%
Blue Shield Non-Epn $23 - $961 22%
Phcs-All Plans $30 - $1,139 28%
Medi-Cal $44 41%
Health Management Network-All Plans $47 - $1,760 44%
Three Rivers-All Plans $50 - $1,864 47%
UnitedHealthcare $62 - $1,320 58%
Aetna $63 - $261 59%
Va Medi-Cal $63 59%
Healthnet-All Plans $112 105%
Va Mcr - All Other Plans $139 130%
Blue Cross Blue Shield $227 - $303 213%
Blue Shield Behav Hlth $311 - $932 291%
Choicecare-All Plans $484 - $1,450 453%
Beech Street-All Plans $519 - $1,553 486%
Galaxy Network-All Plans $623 - $1,864 583%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Woodland Road, Saint Helena, CA 94574
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals