CMS Price Transparency Data

X-ray, lower back

Facility: Central Florida Lake Monroe Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $1,330
Cash Discount Price: $4,158
vs. Medicare Baseline: 12.45x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Central Florida Lake Monroe Hospital is $1,330. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,158. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.45x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.

Cash / Self-Pay

$4,158

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,330

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: $4,158 (3893%)

Insurance Median: $1,330 (1245%)

Cash: $4,158 (3893% of Medicare)

Ins. Median: $1,330 (1245% 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 1245% of the Medicare baseline (a markup of 1145%). 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
United	$245 - $1,871	229%
Freedom Health	$299	280%
Optimum	$299	280%
Simply	$640	599%
Corvel Corporation	$775	726%
Molina Healthcare	$790 - $1,330	740%
Prime Health	$791	741%
Careworks (Rockport Community)	$816	764%
Humana	$832	779%
Evolutions	$956	895%
Avmed	$998 - $2,079	934%
Sunshine State Health Plan	$1,060	992%
Aetna	$1,247	1167%
Florida Health Care Plan	$1,567	1467%
Plotkin Health	$2,079	1946%
Prime Health Sheriff	$2,079	1946%
Multiplan	$3,118 - $3,534	2919%
Three Rivers Provider Network	$3,118	2919%
Ppo Next	$3,534	3309%
Novanet	$3,742	3503%

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 $4,158.
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 Central Florida Lake Monroe 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.