CMS Price Transparency Data

X-ray, lower back

Facility: Jacksonville Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $640
Cash Discount Price: $1,163
vs. Medicare Baseline: 5.99x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Jacksonville Memorial Hospital is $640. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,163. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.99x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$1,163

Average discount available for prompt cash payment at this facility.

Insurance Median

$640

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: $1,163 (1089%)

Insurance Median: $640 (599%)

Cash: $1,163 (1089% of Medicare)

Ins. Median: $640 (599% 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 599% of the Medicare baseline (a markup of 499%). 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
Blue Cross Blue Shield	$47 - $1,163	44%
Tricare	$47 - $212	44%
Coventry	$49 - $183	46%
Health Alliance	$49 - $791	46%
Humana	$49 - $992	46%
Medicare (plans)	$49 - $183	46%
UnitedHealthcare	$52 - $837	49%
Medicaid / KanCare	$110	103%
Molina Healthcare	$110	103%
Corvel/Corcare	$164 - $279	154%
Illinois Workers Compensation	$177 - $406	166%
Commercial Workers Compensation	$386	361%
Health Alliance Mh Employee Plan	$535	501%
Current Health Network	$640 - $872	599%
6 Degrees Health	$698	653%
Hope Trust	$698	653%
Hst	$698	653%
Cigna	$806	755%
Aetna	$813 - $930	761%
Healthlink	$989	926%
Phcs/Multiplan	$1,047	980%
Hfn	$1,105	1035%
Liability	$1,163	1089%

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 $1,163.
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 Jacksonville 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.