CMS Price Transparency Data

X-ray, lower back

Facility: Dorminy Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $91
Cash Discount Price: $234
vs. Medicare Baseline: 0.85x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Dorminy Medical Center is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.85x the Medicare baseline. Located in 200 Perry House Road, Box 1447, Fitzgerald, GA.

Cash / Self-Pay

$234

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $234 (219%)

Insurance Median: $91 (85%)

Cash: $234 (219% of Medicare)

Ins. Median: $91 (85% 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
Healthsmart	$23 - $350	22%
Aetna	$25 - $374	23%
Provider Network Of America	$26 - $397	24%
Cigna	$27 - $411	25%
Humana	$27 - $411	25%
Principal Edge Network	$27 - $407	25%
UnitedHealthcare	$27 - $407	25%
Multiplan	$28 - $421	26%
Novanet	$28 - $421	26%
Phcs	$28 - $421	26%
Unicare	$28 - $421	26%
Three Rivers Provider Network	$29 - $444	27%
Blue Cross Blue Shield	$62 - $91	58%

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 $234.
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 Dorminy Medical Center 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.