CMS Price Transparency Data

X-ray, lower back

Facility: City of Hope National Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $549
Cash Discount Price: $785
vs. Medicare Baseline: 5.14x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at City of Hope National Medical Center is $549. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $785. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.14x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$785

Average discount available for prompt cash payment at this facility.

Insurance Median

$549

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: $785 (735%)

Insurance Median: $549 (514%)

Cash: $785 (735% of Medicare)

Ins. Median: $549 (514% 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 514% of the Medicare baseline (a markup of 414%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Health Net	$30 - $761	28%
Cal Optima	$42 - $61	39%
Heritage Provider Network	$55 - $549	51%
Inland Empire	$57 - $628	53%
Prime Healthcare Keenan	$79 - $753	74%
Blue Cross Blue Shield	$262 - $549	245%
UnitedHealthcare	$380 - $439	356%
Blue Shield	$464 - $935	434%
Blue Shield Covca	$477	447%
Blue Shield Promise	$549	514%
Cigna	$573	536%
Cencal	$628	588%
La Care Health	$628	588%
Kaiser	$706	661%
Aetna	$784	734%
Gold Coast	$784	734%
Molina	$784 - $1,020	734%
Facey	$863	808%
Healthcare Partners	$910	852%
St. Joseph Heritage	$941	881%
Primecare Medical Network	$1,020	955%
First Health	$1,208	1131%
Phcs Multiplan	$1,412	1322%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $785.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm City of Hope National Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72110.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.