X-ray, lower back
Facility: Nmc Health
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $96
- Cash Discount Price: $216
- 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 |
|---|---|---|
| Bluestem Pace | $48 - $101 | 45% |
| Wppa | $56 - $283 | 52% |
| Occunet | $61 - $309 | 57% |
| Samaritan Ministries International | $66 - $335 | 62% |
| Medincrease Health Plan | $66 - $335 | 62% |
| Prime Health Services | $76 - $386 | 71% |
| Aetna | $76 - $83 | 71% |
| Leading Age | $76 - $162 | 71% |
| Medicaid / KanCare | $76 - $162 | 71% |
| UnitedHealthcare | $91 - $464 | 85% |
| Cigna | $96 - $489 | 90% |
| Blue Cross Blue Shield | $248 | 232% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Nmc Health in Newton, KS, the facility's cash price of $216.00 is significantly higher than the state average of $106.81, which is the Medicare benchmark for this service. While commercial insurance plans like Blue Cross Blue Shield and Cigna have negotiated rates ranging from $248 to $489, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. It is important to note that insurance negotiated rates include administrative costs and contract premiums that can inflate the baseline price by 20% to 40%, so the cash price frequently represents the most transparent and affordable option for self-pay patients.
Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the total cost by 20% to 50% by bypassing costly claims processing and administrative overhead. Since over 80% of hospital bills contain errors, consumers should request a full itemized CPT-coded bill rather than accepting a summary invoice, and they should verify their deductible status to avoid paying the full negotiated rate if their plan has not yet covered the service. By comparing the facility's rates directly to the Medicare benchmark and seeking written confirmation of any discounts, patients can avoid unexpected balance billing and ensure they are paying a fair price for their care.