X-ray, lower back
Facility: Stormont Vail Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $96
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.90x 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.
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 | $61 - $93 | 57% |
| Ambetter / Centene | $61 - $93 | 57% |
| Blue Cross Blue Shield | $62 - $784 | 58% |
| Aetna | $96 - $98 | 90% |
| Humana | $96 - $98 | 90% |
Consumer Guidance & Cost Commentary
For an X-ray of the lower back at Stormont Vail Hospital in Topeka, Kansas, the billed gross charge is $832, which is significantly higher than the Medicare benchmark rate of $106.81. While the facility's negotiated rates for commercial payers range from $61 to $98 depending on the insurance plan, these amounts remain well above the Medicare benchmark, illustrating the typical markup between federal reimbursement and commercial pricing. The data indicates that while the facility is a voluntary non-profit with a high rating, patients should be aware that the administrative structures of insurance contracts often result in rates that are several times the true cost of service delivery.
Patients can potentially reduce costs by paying cash directly, as the cash median price is not listed in the provided data, but it is important to note that cash-pay options can sometimes be cheaper than insurance negotiated rates for those with high-deductible plans. Before scheduling, individuals should verify their specific plan's negotiated rate and ask the hospital about "self-pay" or "prompt-pay" discounts, which can offer a fee reduction of 20% to 50% for upfront payment. Additionally, since the No Surprises Act protects against balance billing for emergency and non-emergency services at in-network facilities, patients should request an itemized billing audit if they receive a summary bill to ensure no unbundled codes or services not rendered are included in the final invoice.