CMS Price Transparency Data

X-ray, lower back

Facility: Davis County Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $272
  • Cash Discount Price: $494
  • vs. Medicare Baseline: 2.55x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Davis County Hospital is $272. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $494. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.55x the Medicare baseline. Located in 509 North Madison Street, Bloomfield, IA.
Cash / Self-Pay
$494

Average discount available for prompt cash payment at this facility.

Insurance Median
$272

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: $494 (463%)
Insurance Median: $272 (255%)
Cash: $494 (463% of Medicare)
Ins. Median: $272 (255% 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 255% of the Medicare baseline (a markup of 155%). 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
Blue Cross Blue Shield $66 - $73 62%
Aetna $247 231%
Choicecare Mcr Adv $267 250%
Home State Hlth Exch - All Other Plans $267 250%
Home State Hlth Mcr $267 250%
Mt Carmel Hp-All Plans $267 250%
Tricare $267 250%
Amerigroup Mcr Adv-All Other Plans $272 255%
American Hp Mcr Adv-All Plans $280 262%
Home State Hlth Mcaid $296 277%
Iowa Total Care Mcaid-All Plans $302 283%
Molina Mcaid-All Plans $307 287%
Amerigroup Mcaid $308 288%
Midlands Choice - All Plans $346 324%
Preferred Hlth Choices - All Plans $370 346%
Choicecare Comm - All Other Plans $469 439%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 North Madison Street, Bloomfield, IA 52537
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals