CMS Price Transparency Data

X-ray, lower back

Facility: St Marys Good Samaritan Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $123
  • Cash Discount Price: $296
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at St Marys Good Samaritan Hospital is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $296. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.15x the Medicare baseline. Located in 5401 Lake Oconee Parkway, Greensboro, GA.
Cash / Self-Pay
$296

Average discount available for prompt cash payment at this facility.

Insurance Median
$123

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: $296 (277%)
Insurance Median: $123 (115%)
Cash: $296 (277% of Medicare)
Ins. Median: $123 (115% 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
Peach State $46 43%
Wellcare $46 - $123 43%
Blue Cross Blue Shield $88 - $329 82%
Aetna $123 - $365 115%
Ambetter / Centene $123 115%
Care Improvement Plus $123 115%
Caresource $123 115%
Cigna $123 - $374 115%
Coventry $123 - $342 115%
Eon Health Plan $123 115%
Humana $123 - $342 115%
Kaiser Permanente $123 115%
Molina $123 115%
Pruitthealth Premier $123 115%
Todays Options Pffs $123 115%
Todays Options Ppo $123 115%
UnitedHealthcare $123 - $2,632 115%
Vaccn United $123 115%
First Health $342 320%
Phcs $342 320%
Meritain $365 342%
Multiplan $388 - $397 363%
Nova $388 - $410 363%
Three Rivers Provider Network $410 384%
Amerigroup $456 427%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5401 Lake Oconee Parkway, Greensboro, GA 30642
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals