CMS Price Transparency Data

X-ray, lower back

Facility: Johnson Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $163
  • Cash Discount Price: $309
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Johnson Memorial Hospital is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $309. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.53x the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.
Cash / Self-Pay
$309

Average discount available for prompt cash payment at this facility.

Insurance Median
$163

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: $309 (289%)
Insurance Median: $163 (153%)
Cash: $309 (289% of Medicare)
Ins. Median: $163 (153% 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.

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
Aetna $110 - $138 103%
Connecticut Dept Of Correction $116 109%
Blue Cross Blue Shield $123 - $163 115%
Medicare (plans) $123 - $129 115%
UnitedHealthcare $123 - $561 115%
Cca Senior Care Options $125 117%
Cigna $127 - $438 119%
1199 National Benefit Fund $138 129%
Allied Benefit Systems $138 129%
Gravie Admin Services $138 129%
Hap $138 129%
Luminare Health $138 129%
Meritain $138 129%
Nippon Life Ins $138 129%
Webtpa $138 129%
Bcn Domestic $163 153%
Blue Benefit Administrators Of Massachusetts $163 153%
Blue Care Network $163 153%
Blue Distinction Transplant $163 153%
Blue Shield - Ca $163 153%
Blue Shield - Id (Regence) $163 153%
Blue Shield - Ny Highmark Northeastern $163 153%
Blue Shield - Ny Highmark Western $163 153%
Blue Shield - Pa (Highmark) $163 153%
Blue Shield - Wa (Regence) $163 153%
Fallon Health $163 153%
Health Choices $163 153%
Kaiser Domestic $163 153%
Pre-Employment $163 153%
Unicare $163 153%
Wc Domestic $163 153%
Wellpoint $163 153%
Geha $179 168%
Harvard Pilgrim Healthcare $179 168%
Connecticare $194 - $242 182%
Claimdoc $263 246%
Diversified Administrators $263 246%
Innovative Health Plan Ii $263 246%
Centivo $292 273%
Allegiance $356 333%
Health Partners $356 333%
Magnacare $356 333%
Health New England $365 342%
Prime Health Services $449 420%
Allied National Global Care $466 436%
Asrm - Reliance Standard Life Insurance $466 436%
Christian Care Ministry $466 436%
Dean Health $466 436%
Family Life Insurance Company $466 436%
Ghc Scw $466 436%
International Benefit Administrators $466 436%
Lifetime Benefit Solutions $466 436%
Manhattan Life $466 436%
Medi Share $466 436%
Multiplan $466 436%
Mvp $466 436%
Pai $466 436%
Pan-American Life $466 436%
Paramount Hmo $466 436%
Phcs $466 436%
Trinity Health Share $466 436%
Health Smart $477 447%
United Behavioral Health Eap $561 525%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Chestnut Hill Road, Stafford Springs, CT 06076
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals