CMS Price Transparency Data

X-ray, lower back

Facility: Pinckneyville Community Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $219
Cash Discount Price: $350
vs. Medicare Baseline: 2.05x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Pinckneyville Community Hospital is $219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $350. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.05x the Medicare baseline. Located in 5383 State Route 154, Pinckneyville, IL.

Cash / Self-Pay

$350

Average discount available for prompt cash payment at this facility.

Insurance Median

$219

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: $350 (328%)

Insurance Median: $219 (205%)

Cash: $350 (328% of Medicare)

Ins. Median: $219 (205% 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 205% of the Medicare baseline (a markup of 105%). 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	$12 - $214	11%
Aetna	$13 - $521	12%
Umwa Mcr Adv - All Plans	$13 - $214	12%
UnitedHealthcare	$13 - $475	12%
Wellcare Mcr Adv - All Plans	$13 - $214	12%
Cigna	$15 - $478	14%
Blue Cross Blue Shield	$26 - $417	24%
Healthlink Hmo	$74 - $455	69%
Healthlink Ppo - All Other Plans	$74 - $478	69%
Phcs Savility	$102 - $492	95%
Multiplan - All Plans	$108 - $521	101%
Phcs - All Other Plans	$108 - $475	101%
Ambetter / Centene	$297 - $307	278%
Medicaid / KanCare	$297 - $307	278%
Healthlink Work Comp	$478	448%

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 $350.
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 Pinckneyville 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.