CMS Price Transparency Data

X-ray, lower back

Facility: Hamilton Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $272
Cash Discount Price: $301
vs. Medicare Baseline: 2.55x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Hamilton Memorial Hospital is $272. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $301. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.55x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.

Cash / Self-Pay

$301

Average discount available for prompt cash payment at this facility.

Insurance Median

$272

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: $301 (282%)

Insurance Median: $272 (255%)

Cash: $301 (282% of Medicare)

Ins. Median: $272 (255% 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 255% of the Medicare baseline (a markup of 155%). 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
Aetna	$50 - $318	47%
Blue Cross Blue Shield	$50 - $322	47%
Health Alliance	$50 - $283	47%
Medicare (plans)	$50 - $142	47%
UnitedHealthcare	$50 - $253	47%
Wellcare	$50 - $142	47%
Medicaid / KanCare	$132 - $142	124%
Humana	$142	133%
Alliance Coal	$248	232%
Healthscope	$248	232%
Wellfirst (Ssmhic)	$248	232%
Hope Trust	$265	248%
Cigna	$278	260%
Hfn, Inc	$283 - $318	265%
Healthlink	$301 - $318	282%
Multiplan	$301	282%
Siho	$318	298%
Three Rivers Provider	$318	298%
Healthsmart	$336	315%
Stratose	$336	315%

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 $301.
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 Hamilton 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.