CMS Price Transparency Data

X-ray, lower back

Facility: Adventist Health Ukiah Valley

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $78
Cash Discount Price: $19
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Adventist Health Ukiah Valley is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.73x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$19

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $19 (18%)

Insurance Median: $78 (73%)

Cash: $19 (18% of Medicare)

Ins. Median: $78 (73% 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.

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
Blue Shield Mcr Adv	$13 - $144	12%
Kaiser Mcr Adv	$13 - $144	12%
Tricare	$13 - $144	12%
Ah Employee Health Plan - All Plans	$14 - $259	13%
Cigna	$16 - $1,115	15%
UnitedHealthcare	$16 - $1,195	15%
Healthnet-All Plans	$19 - $818	18%
Western Growers-All Plans	$19 - $601	18%
Blue Shield Epn-All Other Plans	$21 - $545	20%
Blue Shield Non-Epn	$22 - $552	21%
Mendocino Lcc District-All Plans	$32 - $930	30%
Aetna	$37 - $276	35%
Kaiser-All Other Plans	$40 - $1,144	37%
Kaiser Medi-Cal	$44 - $63	41%
Medi-Cal	$44 - $63	41%
Three Rivers-All Plans	$45 - $1,287	42%
Foundation For Medical Care-All Plans	$70 - $1,072	66%
Networks By Design-All Plans	$75 - $1,144	70%
Phcs Multiplan-All Plans	$75 - $1,144	70%
Interplan-All Plans	$77 - $1,173	72%
Beech Street-All Plans	$80 - $1,216	75%
Choice Care-All Plans	$80 - $1,216	75%
Health Mgmt Network-All Plans	$80 - $1,216	75%
Blue Cross Blue Shield	$265 - $353	248%

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 $19.
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 Adventist Health Ukiah Valley 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.