CMS Price Transparency Data

X-ray, lower back

Facility: Adventist Health Castle

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $306
Cash Discount Price: $160
vs. Medicare Baseline: 2.86x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Adventist Health Castle is $306. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.86x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$160

Average discount available for prompt cash payment at this facility.

Insurance Median

$306

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: $160 (150%)

Insurance Median: $306 (286%)

Cash: $160 (150% of Medicare)

Ins. Median: $306 (286% 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 286% of the Medicare baseline (a markup of 186%). 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
Multiplan Hmn - All Plans	$18	17%
UnitedHealthcare	$32	30%
Hmsa Hmo	$61	57%
Hmsa Ppo - All Other Plans	$61	57%
Alohacare Quest Mcaid - All Other Plans	$93 - $158	87%
Kfh Mcr Adv	$124	116%
Medicare (plans)	$124	116%
Ohana Health Plan - All Plans	$126	118%
Devoted Hlth Mcr Adv - All Plans	$130	122%
Pacific Admin Ppo - All Plans	$236 - $402	221%
Hwmg/Hmaa - All Plans	$273 - $465	256%
Mdx Hawaii Ppo - All Plans	$296 - $505	277%
Health Alliance - All Plans	$297 - $506	278%
Kfh - All Other Plans	$315 - $537	295%
Uni Health Alliance - All Plans	$346 - $590	324%
First Health Ppo - All Plans	$349 - $594	327%
Medicaid / KanCare	$371 - $632	347%
State Of Hi Nonprofit - All Plans	$649 - $1,106	608%

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 $160.
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 Adventist Health Castle 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.