CMS Price Transparency Data

X-ray, lower back

Facility: Pulaski Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $47
Cash Discount Price: $384
vs. Medicare Baseline: 0.44x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Pulaski Memorial Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $384. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.44x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$384

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $384 (360%)

Insurance Median: $47 (44%)

Cash: $384 (360% of Medicare)

Ins. Median: $47 (44% 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.

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
Ambetter / Centene	$12 - $328	11%
Blue Cross Blue Shield	$12 - $704	11%
Caresource Mcaid Hip	$12 - $328	11%
Caresource Mcare Hmo	$12 - $328	11%
Cenpatico Mcaid Hip	$12 - $328	11%
Humana	$12 - $851	11%
Mdwise Mcaid Hcc	$12 - $23	11%
Mdwise Mcaid Hhw	$12 - $23	11%
Mdwise Mcaid Hip - All Other Plans	$12 - $328	11%
Mhs Mcaid Hip	$12 - $328	11%
Mhs Mcare Allwell	$12 - $332	11%
Multiplan - All Plans	$12 - $953	11%
UnitedHealthcare	$12 - $836	11%
Caresource Exch Hmo Hix - All Other Plans	$15 - $410	14%
Encore Ppo - All Other Plans	$18 - $900	17%
Caresource Mcaid Hhw	$23 - $47	22%
Cenpatico Mcaid Hhw - All Other Plans	$23 - $47	22%
Community Health Alliance - All Plans	$23 - $942	22%
Mhs Mcaid Hhw/Hcc	$23 - $47	22%
Cigna	$24 - $1,006	22%
Sagamore - All Other Plans	$24 - $800	22%
Sagamore Rose Acre	$24 - $789	22%
Encore Workers Comp	$34 - $953	32%
Aetna	$381	357%

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 $384.
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 Pulaski 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.