CMS Price Transparency Data

X-ray, lower back

Facility: Mc Donough District Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $96
Cash Discount Price: $226
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Mc Donough District Hospital is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $226. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.90x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.

Cash / Self-Pay

$226

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

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: $226 (212%)

Insurance Median: $96 (90%)

Cash: $226 (212% of Medicare)

Ins. Median: $96 (90% 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
Health Alliance	$7 - $575	7%
Hfn	$11 - $581	10%
UnitedHealthcare	$11 - $581	10%
Aetna	$12 - $646	11%
Humana	$12 - $581	11%
Medicaid / KanCare	$12 - $646	11%
Medicare (plans)	$12 - $119	11%
Meridian	$12 - $119	11%
Molina	$12 - $646	11%
Mutual Medical	$12 - $646	11%
Veteran Affairs	$12 - $119	11%
Blue Cross Blue Shield	$70 - $646	66%
Springfield Health	$88 - $530	82%
Consociate	$91 - $549	85%
Trilogy	$91 - $549	85%
Blue Choice	$96 - $581	90%
Current Health	$96 - $581	90%
Healthlink	$96 - $607	90%
Preferred Plan	$102 - $614	95%
Tricare	$111	104%

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 $226.
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 Mc Donough District 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.