CMS Price Transparency Data

X-ray, lower back

Facility: Adventist Health Mendocino Coast

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $63
Cash Discount Price: $364
vs. Medicare Baseline: 0.59x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Adventist Health Mendocino Coast is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $364. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.59x the Medicare baseline. Located in 700 River Drive, Fort Bragg, CA.

Cash / Self-Pay

$364

Average discount available for prompt cash payment at this facility.

Insurance Median

$63

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: $364 (341%)

Insurance Median: $63 (59%)

Cash: $364 (341% of Medicare)

Ins. Median: $63 (59% 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
Cigna	$13 - $821	12%
Tricare	$13 - $516	12%
UnitedHealthcare	$13 - $852	12%
Ah Employee Health Plan - All Plans	$14 - $548	13%
Blue Cross Blue Shield	$16 - $238	15%
Healthnet - All Plans	$19 - $686	18%
Blue Shield Epn	$21 - $398	20%
Blue Shield - All Other Plans	$22 - $809	21%
Medi-Cal	$44 - $63	41%
Ahcc - All Plans	$50 - $948	47%
Beech Street - All Plans	$50 - $948	47%
Great West Hmo/Pos/Epo/Oa	$50 - $684	47%
Great West Ppo - All Other Plans	$50 - $737	47%
Multiplan - All Plans	$50 - $737	47%
Partnership Hp Mcal-All Plans	$50 - $189	47%

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 $364.
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 Mendocino Coast 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.