CMS Price Transparency Data

X-ray, lower back

Facility: Van Diest Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $166
Cash Discount Price: $190
vs. Medicare Baseline: 1.55x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Van Diest Medical Center is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.55x the Medicare baseline. Located in 2350 Hospital Drive, Webster City, IA.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$166

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: $190 (178%)

Insurance Median: $166 (155%)

Cash: $190 (178% of Medicare)

Ins. Median: $166 (155% 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
Humana	$107	100%
Medical Associates	$107 - $178	100%
Amerigroup	$108 - $137	101%
Partners Health Alliance	$123	115%
Aetna	$135 - $213	126%
Iowa Total Care	$135	126%
Molina Healthcare	$137	128%
UnitedHealthcare	$140 - $213	131%
Midlands Choice	$166	155%
Health Alliance-Midwest, Inc. Of Ia	$178	167%

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 $190.
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 Van Diest 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.