CMS Price Transparency Data

X-ray, lower back

Facility: Marion Communtiy Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $1,194
Cash Discount Price: $4,754
vs. Medicare Baseline: 11.18x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Marion Communtiy Hospital is $1,194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,754. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.18x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.

Cash / Self-Pay

$4,754

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,194

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: $4,754 (4451%)

Insurance Median: $1,194 (1118%)

Cash: $4,754 (4451% of Medicare)

Ins. Median: $1,194 (1118% 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 1118% of the Medicare baseline (a markup of 1018%). 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 - $2,238	229%
Avmed	$544 - $1,393	509%
Simply	$698 - $766	653%
Corvel Corporation	$738	691%
Prime Health	$754	706%
Careworks (Rockport Community)	$777	727%
Marion County Schools	$777	727%
Molina Healthcare	$861 - $1,592	806%
Humana	$907 - $995	849%
Evolutions	$1,043 - $1,144	977%
Evolutions Healthcare	$1,043 - $1,144	977%
Sunshine State Health Plan	$1,156 - $1,268	1082%
Aetna	$1,360 - $1,492	1273%
Plotkin Health	$2,267 - $2,487	2122%
Prime Health Sheriff	$2,267 - $2,487	2122%
Multiplan	$3,536 - $3,880	3311%
Ppo Next	$3,854 - $4,228	3608%
Novanet	$4,080 - $4,477	3820%

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 $4,754.
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 Marion Communtiy 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.