CMS Price Transparency Data

X-ray, lower back

Facility: Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $766
Cash Discount Price: $681
vs. Medicare Baseline: 7.17x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Memorial Hospital is $766. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $681. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.17x the Medicare baseline. Located in 1454 N County Road 2050 E, Carthage, IL.

Cash / Self-Pay

$681

Average discount available for prompt cash payment at this facility.

Insurance Median

$766

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: $681 (638%)

Insurance Median: $766 (717%)

Cash: $681 (638% of Medicare)

Ins. Median: $766 (717% 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 717% of the Medicare baseline (a markup of 617%). 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
Humana	$235 - $851	220%
Aetna	$238 - $851	223%
Blue Cross Blue Shield	$238 - $851	223%
Cigna	$238 - $851	223%
Health Alliance	$238 - $851	223%
Meridian	$238 - $851	223%
Molina	$238 - $851	223%
UnitedHealthcare	$238 - $851	223%
Consociate	$558 - $851	522%
Healthlink	$723 - $851	677%
Private Healthcare Systems	$723	677%
Integrated Health Plan	$749	701%
First Health Network	$757 - $851	709%
Health Dynamics	$766	717%
Health Payors Org	$766	717%
Iowa Health Solutions	$766	717%
Multiplan	$766	717%
Preferred Plan Inc	$766	717%
Three Rivers Provider Network	$766	717%
Health First Network	$774	725%
Pponext	$774	725%
Corvel	$808	756%

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 $681.
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 Memorial 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.