CMS Price Transparency Data

X-ray, lower back

Facility: Mercyone Clinton Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $240
  • Cash Discount Price: $585
  • vs. Medicare Baseline: 2.25x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Mercyone Clinton Medical Center is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $585. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.25x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$585

Average discount available for prompt cash payment at this facility.

Insurance Median
$240

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: $585 (548%)
Insurance Median: $240 (225%)
Cash: $585 (548% of Medicare)
Ins. Median: $240 (225% 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 225% of the Medicare baseline (a markup of 125%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Iowa Total Care $96 90%
Medicaid / KanCare $97 - $98 91%
Bcn Domestic $107 100%
Blue Benefit Administrators Of Massachusetts $107 100%
Blue Care Network $107 100%
Blue Cross Blue Shield $107 - $110 100%
Blue Distinction Transplant $107 100%
Blue Shield - Ca $107 100%
Blue Shield - Id (Regence) $107 100%
Blue Shield - Ny Highmark Northeastern $107 100%
Blue Shield - Ny Highmark Western $107 100%
Blue Shield - Pa (Highmark) $107 100%
Blue Shield - Wa (Regence) $107 100%
Kaiser Domestic $107 100%
Pre-Employment $107 100%
Wc Domestic $107 100%
Aetna $109 - $788 102%
Medicare (plans) $109 - $114 102%
UnitedHealthcare $111 - $900 104%
Amish Hospital Aid $148 139%
Oscar $152 142%
Ambetter / Centene $187 175%
Claimdoc $224 210%
Nova $224 210%
Geha $240 225%
Health Choices $255 239%
Medical Associates $255 239%
Preferred Health Choice $260 243%
The Alliance $546 511%
1199 National Benefit Fund $788 738%
Allied Benefit Systems $788 738%
Asr Health Benefits $788 738%
Christian Brother Services $788 738%
Coventry $788 738%
First Health $788 738%
Lucent Health $788 738%
Luminare Health $788 738%
Medical Mutual $788 738%
Meritain $788 738%
Trustmark Small Business Benefits $788 738%
Webtpa $788 738%
Health Partners $789 739%
Auxiant $810 758%
Cigna $810 758%
Medica $810 758%
Midlands $810 758%
Midlands Choice $810 758%
Multiplan $810 758%
Qualcare $810 758%
Usa Managed Care $855 800%
Crime Victim Assistance $900 843%
Iowa Dept Of Public Health $900 843%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals