CMS Price Transparency Data

X-ray, lower back

Facility: Palos Community Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $974
Cash Discount Price: $909
vs. Medicare Baseline: 9.12x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Palos Community Hospital is $974. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $909. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.12x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$909

Average discount available for prompt cash payment at this facility.

Insurance Median

$974

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: $909 (851%)

Insurance Median: $974 (912%)

Cash: $909 (851% of Medicare)

Ins. Median: $974 (912% 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 912% of the Medicare baseline (a markup of 812%). 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
Blue Cross Blue Shield	$208 - $1,299	195%
Aetna	$279 - $1,299	261%
Carelon Behavioral Health [159]	$650	609%
Healthlink [125]	$650 - $1,299	609%
First Health Plan [6034]	$738 - $974	691%
Magellan Behavioral Hlth [136]	$779	729%
The Alliance [1703]	$834	781%
Compsych [112]	$974	912%
Beechstreet [176]	$1,039	973%
Cigna	$1,039 - $1,299	973%
Health'S Finest Network [126]	$1,104	1034%
Galaxy Health Network [220]	$1,299	1216%
Global Excel [1712]	$1,299	1216%
Health Alliance [181]	$1,299	1216%
Multiplan/Phcs [142]	$1,299	1216%
UnitedHealthcare	$1,299	1216%

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 $909.
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 Palos Community Hospital 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.