CMS Price Transparency Data

X-ray, lower back

Facility: Mayers Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $359
Cash Discount Price: $445
vs. Medicare Baseline: 3.36x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Mayers Memorial Hospital is $359. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $445. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.36x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.

Cash / Self-Pay

$445

Average discount available for prompt cash payment at this facility.

Insurance Median

$359

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: $445 (417%)

Insurance Median: $359 (336%)

Cash: $445 (417% of Medicare)

Ins. Median: $359 (336% 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 336% of the Medicare baseline (a markup of 236%). 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
Blue Shield Ca Va	$12 - $341	11%
Blue Shield Mcr Adv	$12 - $341	11%
Tricare	$12 - $359	11%
Health Net Mcr Adv	$13 - $359	12%
Arcadian Health Services-All Plans	$14 - $359	13%
Imperial Health Plan-All Plans	$15 - $406	14%
Medi-Cal	$44 - $63	41%
Partnership Hp-All Plans	$252	236%
Cigna	$328 - $517	307%
Corvel Ppo-All Plans	$328 - $517	307%
Coventry/First Health-All Plans	$328 - $517	307%
Integrated Hp-All Plans	$328 - $517	307%
Interplan-All Plans	$328 - $517	307%
Blue Cross Blue Shield	$363 - $465	340%
Health Net Prison	$392	367%
Blue Shield Ca Exchange	$465	435%
Blue Shield-All Other Plans	$517	484%
Hmn-All Plans	$517	484%
Multiplan Phcs-All Plans	$517	484%
Pfmc-All Plans	$517	484%
Superior Ca-All Plans	$517	484%
Health Net-All Other Plans	$541	507%
Pacificare-All Plans	$544	509%

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 $445.
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 Mayers Memorial Hospital 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.