CMS Price Transparency Data

X-ray, lower back

Facility: Methodist Hospitals Inc

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $670
Cash Discount Price: $1,054
vs. Medicare Baseline: 6.27x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Methodist Hospitals Inc is $670. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,054. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.27x the Medicare baseline. Located in 600 Grant St, Gary, IN.

Cash / Self-Pay

$1,054

Average discount available for prompt cash payment at this facility.

Insurance Median

$670

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: $1,054 (987%)

Insurance Median: $670 (627%)

Cash: $1,054 (987% of Medicare)

Ins. Median: $670 (627% 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 627% of the Medicare baseline (a markup of 527%). 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	$91 - $1,304	85%
Caresource	$91	85%
Humana	$91 - $110	85%
Managed Health Services	$91	85%
Medicaid / KanCare	$91	85%
UnitedHealthcare	$91 - $679	85%
Aetna	$110 - $1,122	103%
Medicare (plans)	$110	103%
United Heathcare	$110	103%
Zing	$112	105%
Caresource Maketplace	$182	170%
Ambetter / Centene	$220	206%
Magnacare	$523	490%
Cigna	$574 - $632	537%
Physicians Health Plan Of Northern Indiana	$864 - $876	809%
Encore	$897 - $1,349	840%
Phcs	$1,017 - $1,031	952%
Siho	$1,046 - $1,061	979%
Sagamore	$1,076 - $1,092	1007%
Multiplan	$1,091 - $1,107	1021%
Hfn	$1,166 - $1,289	1092%

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 $1,054.
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 Methodist Hospitals Inc 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.