CMS Price Transparency Data

X-ray, lower back

Facility: Sonoma Valley Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $959
  • Cash Discount Price: $1,074
  • vs. Medicare Baseline: 8.98x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Sonoma Valley Hospital is $959. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,074. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.98x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$1,074

Average discount available for prompt cash payment at this facility.

Insurance Median
$959

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: $1,074 (1006%)
Insurance Median: $959 (898%)
Cash: $1,074 (1006% of Medicare)
Ins. Median: $959 (898% 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 898% of the Medicare baseline (a markup of 798%). 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
Aetna $46 43%
First Health(Coventry)-All Plans $46 43%
Medi-Cal $63 59%
Mcal Mgd Care (Php)-All Plans $104 97%
Tricare $141 132%
Blue Cross Blue Shield $144 - $1,006 135%
Bright Hlth/Brand New Day Mcr Adv $144 135%
Hospice Of Marin-All Plans $144 135%
St Joseph Heritage Hltcare Comm-All Other Plans $144 135%
Veterans Admin-All Plans $144 135%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $151 141%
Cdcr Prison-All Plans $173 162%
Three Rivers (Trpn)-All Plans $173 162%
Chp - Correctional Health Partners - All Plans $187 175%
Bright Hlth/Brand New Day - All Other Plands $194 182%
Wellpath - All Plans $201 188%
Partnership Healthplan-All Plans $220 206%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $259 242%
Canopy Health Solutions-All Other Plans $259 242%
Healthnet Hmo/Ppo-All Other Plans $537 503%
Blue Shield Ppo-All Plans $871 815%
UnitedHealthcare $920 861%
Kaiser-All Plans $997 933%
Comm Care Network(Ccn)-All Plans $1,000 936%
Integrated Health Plan-All Plans $1,135 1063%
Champus-All Plans $1,227 1149%
Cigna $1,227 1149%
Networks By Design - All Plans $1,227 1149%
Great West-One Health Plan Ppo/Pos-All Plans $1,304 1221%
Phcs/Multiplan/Beech St-All Plans $1,304 1221%
Interplan-All Plans $1,350 1264%
Bps-All Plans $1,381 1293%
Ppo Alliance-All Plans $1,381 1293%
Pref Health Networl(Phn)-All Plans $1,381 1293%
Meritage Medical Network Op Only Mcare $1,534 1436%
Scan Mcare-All Plans $1,534 1436%
St Joseph Heritage Hltcare Mcr Adv $1,534 1436%
Correct Care Integ Health-All Plans $1,841 1724%
Employer Direct Healthcare-All Plans $1,841 1724%
Meritage Medical Network Op Only-All Other Plans $1,933 1810%
Creative Legal Services-All Plans $1,994 1867%
Canopy Op Only $2,761 2585%
Vnpn - All Plans $2,761 2585%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals