CMS Price Transparency Data

X-ray, lower back

Facility: Jefferson County Health Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $174
  • Cash Discount Price: $249
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Jefferson County Health Center is $174. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $249. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.63x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$249

Average discount available for prompt cash payment at this facility.

Insurance Median
$174

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: $249 (233%)
Insurance Median: $174 (163%)
Cash: $249 (233% of Medicare)
Ins. Median: $174 (163% 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
Wellmark Hmo $59 55%
Wellmark Indemnity/Ppo - All Other Plans $65 61%
UnitedHealthcare $141 - $374 132%
Tricare $161 151%
Amerigroup Mcr Adv $166 155%
Humana $166 155%
Iowa Total Care Comm - All Other Plans $166 155%
Iowa Total Care Mcr $166 155%
Molina Mcr Adv $166 155%
Iowa Total Care Mcaid $174 163%
Molina Mcaid/Chip $174 163%
Medicaid / KanCare $178 167%
Aetna $203 - $374 190%
Medicare (plans) $203 190%
Midlands New Product $340 318%
Coventry Commercial Hmo $353 330%
Coventry Commercial Ppo - All Other Plans $374 350%
Midlands Choice-All Other Plans $374 350%
Molina Marketplace - All Other Plans $415 389%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals