CMS Price Transparency Data

X-ray, lower back

Facility: Witham Health Services

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $848
Cash Discount Price: $862
vs. Medicare Baseline: 7.94x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Witham Health Services is $848. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $862. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.94x the Medicare baseline. Located in 2605 N Lebanon St, Lebanon, IN.

Cash / Self-Pay

$862

Average discount available for prompt cash payment at this facility.

Insurance Median

$848

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: $862 (807%)

Insurance Median: $848 (794%)

Cash: $862 (807% of Medicare)

Ins. Median: $848 (794% 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 794% of the Medicare baseline (a markup of 694%). 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	$23 - $970	22%
Mdwise Health In-All Plans	$111	104%
Caresource Mcr Adv	$113	106%
Aetna	$114 - $911	107%
Caresource Indiana Marketplace-All Other Plans	$210	197%
UnitedHealthcare	$961	900%
Phcs/Multiplan-All Plans	$1,121	1050%
Sagamore-All Plans	$1,133	1061%
Humana	$1,145	1072%
Beech Street-All Plans	$1,158	1084%
Encore-All Plans	$1,170	1095%
Mhs Comml Exch-All Plans	$3,079	2883%

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 $862.
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 Witham Health Services 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.