CMS Price Transparency Data

X-ray, lower back

Facility: HSHS St Elizabeth's Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $814
  • Cash Discount Price: $910
  • vs. Medicare Baseline: 7.62x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at HSHS St Elizabeth's Hospital is $814. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $910. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.62x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$910

Average discount available for prompt cash payment at this facility.

Insurance Median
$814

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: $910 (852%)
Insurance Median: $814 (762%)
Cash: $910 (852% of Medicare)
Ins. Median: $814 (762% 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 762% of the Medicare baseline (a markup of 662%). 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
Aetna $44 - $890 41%
Blue Cross Blue Shield $44 - $1,264 41%
Claim Doc $44 - $297 41%
Clear Spring Health Of Illinois $44 - $119 41%
Health Alliance Medical Plans $44 - $1,074 41%
Health Partners $44 - $119 41%
Hopetrust $44 - $285 41%
Humana $44 - $119 41%
Molina Healthcare $44 - $124 41%
Naphcare $44 - $257 41%
Sae Hospice $44 - $119 41%
UnitedHealthcare $44 - $1,264 41%
Meridian Health Plan $54 51%
Celtic Insurance Company $237 222%
Amish Community $354 331%
Wellfirst $814 762%
Cigna $916 - $1,264 858%
First Health $940 880%
Healthlink $1,005 - $1,264 941%
Caterpillar, Inc. $1,015 950%
Consociate Group $1,112 1041%
Choicecare $1,138 1065%
Healthcare Finest Network (Hfn) $1,138 1065%
Multiplan/Phcs $1,138 1065%
Provider Network Of America $1,138 1065%
City Of Springfield $1,264 1183%
Current Health Solutions $1,264 1183%
Healthscope $1,264 1183%
Illinois Breast And Cervical Cancer Program $1,264 1183%
Interplan $1,264 1183%
Live360 $1,264 1183%
Wexford $1,264 1183%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals