X-ray, lower back
Facility: Lmh
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $105
- Cash Discount Price: $300
- vs. Medicare Baseline: 0.98x 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 | $39 - $797 | 37% |
| Medicare (plans) | $39 - $105 | 37% |
| Humana | $39 - $105 | 37% |
| Cigna | $39 - $802 | 37% |
| Blue Cross Blue Shield | $46 - $776 | 43% |
| Haskell Indian Health Services | $46 - $105 | 43% |
| Ambetter / Centene | $47 - $163 | 44% |
| Allwell | $47 - $107 | 44% |
| Aetna | $764 - $996 | 715% |
| Non Contracted | $960 | 899% |
| First Health | $1,116 | 1045% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back), the facility in Lawrence, KS, lists a cash median price of $300.00, which is significantly lower than the gross charge of $1,200.00. While the facility is a government-owned acute care hospital, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. For instance, UnitedHealthcare and Cigna have negotiated ranges extending up to $797 and $802 respectively, whereas the cash rate remains at $300.00. This suggests that for patients with high-deductible plans or those without insurance, paying the cash price directly may result in lower out-of-pocket costs compared to the insurance negotiated amounts.
To ensure you are receiving the best possible rate, it is crucial to request an itemized billing audit before finalizing payment, as summary bills can obscure individual charges or unbundled services. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the total amount owed by 20% to 50% if paid upfront, bypassing the costly insurance claims process. When comparing this facility's pricing to broader benchmarks, note that the Medicare amount for this service is $106.81, serving as a baseline for fair pricing. While the facility's cash rate is higher than the Medicare amount, it remains substantially below the gross charges and many commercial negotiated rates, indicating a potentially favorable position for self-pay patients.