CMS Price Transparency Data

X-ray, lower back

Facility: Adventist Health Sonora

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $238
  • Cash Discount Price: $230
  • vs. Medicare Baseline: 2.23x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Adventist Health Sonora is $238. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $230. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.23x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.
Cash / Self-Pay
$230

Average discount available for prompt cash payment at this facility.

Insurance Median
$238

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: $230 (215%)
Insurance Median: $238 (223%)
Cash: $230 (215% of Medicare)
Ins. Median: $238 (223% 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 223% of the Medicare baseline (a markup of 123%). 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 Mcare $13 - $144 12%
Central Ca Alliance Mcr Adv Profee Only $13 12%
Healthnet Mcr Adv $13 - $144 12%
Tricare $13 - $144 12%
UnitedHealthcare $13 - $1,258 12%
Ah Employee Health Plan - All Plans $14 - $259 13%
Cigna $16 - $1,390 15%
Greatwest Oa/Pos/Hmo $17 - $1,244 16%
Greatwest Ppo - All Other Plans $17 - $1,317 16%
Healthnet - All Other Plans $19 - $1,282 18%
Western Growers/Pinnacle - All Plans $19 - $775 18%
Blue Shield Epn $21 - $1,109 20%
Blue Shield - All Other Plans $22 - $1,112 21%
Bc Mcal $44 41%
Celtic Ca Hlth Well Mcal - All Plans $44 - $87 41%
Central Ca Alliance Mcal $44 - $71 41%
Healthnet Mcal $44 - $94 41%
Medi-Cal $44 - $63 41%
Beech Street- All Plans $45 - $1,244 42%
Trpn - Three Rivers Ppo - All Plans $45 - $1,170 42%
Central Ca Alliance Ccs Mcal $50 - $71 47%
Central Ca Alliance Chdp Mcal $50 - $71 47%
Central Ca Alliance Comm Profee Only-All Other Pla $50 47%
Aetna $73 - $458 68%
Phs Prime Health Srvcs-All Plans $144 135%
Bc Exchange $238 223%
Bc Non-Mcs - All Other Plans $265 248%
Bc Mcs $318 298%
Kaiser - All Plans $676 - $732 633%
Affordable Health - All Plans $1,218 - $1,317 1140%
Interplan - All Plans $1,218 - $1,317 1140%
Multiplan - All Plans $1,218 - $1,317 1140%
Phcs Ppo - All Plans $1,218 - $1,317 1140%
Stanilaus Foundation - All Plans $1,285 - $1,390 1203%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Greenley Road, Sonora, CA 95370
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals