X-ray, lower back
Facility: Susan B Allen Memorial Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $554
- Cash Discount Price: $260
- vs. Medicare Baseline: 5.19x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 519% of the Medicare baseline (a markup of 419%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $350 | 328% |
| Providrs Care | $757 | 709% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back), Susan B Allen Memorial Hospital in El Dorado, KS, lists a cash price of $260.00, which is lower than the facility's gross charge of $400.00. While the hospital's negotiated rates with UnitedHealthcare and Providrs Care are $350.00 and $757.00 respectively, these amounts may not be the lowest option for patients with high-deductible plans. In such cases, paying the cash price directly can sometimes be more cost-effective than relying on insurance, especially if the insurer's negotiated rate exceeds the cash price. Patients should verify their specific plan details and ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
This service is benchmarked against the Medicare rate of $106.81, showing a 5.2% increase over the federal baseline. It is important to note that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price, whereas Medicare rates represent a more objective cost baseline. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, where the provider bills you for the difference between their full charge and what your insurance allowed. To avoid this, ensure you have a signed waiver of insurance submission if paying cash, and always request a full itemized bill to identify any errors, unbundled codes, or services not rendered before making a payment.