X-ray, lower back
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $138
- Cash Discount Price: $464
- vs. Medicare Baseline: 1.29x 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 |
|---|---|---|
| Humana | $33 - $104 | 31% |
| Medicaid / KanCare | $33 - $102 | 31% |
| Aetna | $33 - $102 | 31% |
| Provider Partners Health Plans Contracted [320450] | $35 | 33% |
| First Health Contracted [320128] | $37 | 35% |
| Blue Cross Blue Shield | $60 - $201 | 56% |
| UnitedHealthcare | $91 - $660 | 85% |
| Kindful Hospice Contracted [320434] | $102 | 95% |
| Medicare (plans) | $102 | 95% |
| Qual Choice Contracted [320325] | $102 | 95% |
| Medical Associates Health Contracted [320444] | $102 | 95% |
| Cigna | $102 - $467 | 95% |
| Mercy Hospice Okc [20252] | $102 | 95% |
| Cherokee Nation Health Serv Contracted [320066] | $102 | 95% |
| Pace Of The Ozarks Contracted [320518] | $102 | 95% |
| Globalhealth Contracted [320145] | $102 | 95% |
| Kindful Hospice [20434] | $102 | 95% |
| United Medical Resources Contracted [320454] | $102 - $138 | 95% |
| Mercy Mgd Behavioral Health Contracted [320259] | $102 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $102 | 95% |
| Halo Hcr Inc Hospice [20432] | $102 | 95% |
| Cross Timbers Hospice [20098] | $102 | 95% |
| Tricare | $102 | 95% |
| Elara Caring Aspire Hospice [20433] | $102 | 95% |
| Dept Of Veteran Affairs Contracted [320106] | $104 | 97% |
| Centivo Contracted [320505] | $104 | 97% |
| Healthscope Contracted [320182] | $138 - $536 | 129% |
| Health Systems Inc Contracted [320174] | $138 | 129% |
| Benefit Management Contracted [320052] | $138 | 129% |
| Point C Contracted [320238] | $138 - $536 | 129% |
| Insurance System Inc Contracted [320465] | $138 | 129% |
| Providrs Care Network Contracted [320484] | $197 | 184% |
| Show-Me Health Administrators Contracted [320483] | $241 | 226% |
| Mercy Benefit Admin Contracted [320251] | $241 - $500 | 226% |
| Medica Contracted [320239] | $260 | 243% |
| American Healthcare Alliance Contracted [320020] | $500 | 468% |
| Ebms Contracted [320493] | $500 | 468% |
| Auxiant Contracted [320462] | $500 - $536 | 468% |
| Edison Health Solutions Contracted [320502] | $500 | 468% |
| Yuzu Health Contracted [320521] | $500 | 468% |
| Aither Health Contracted [320449] | $500 | 468% |
| Reflect Health Contracted [320492] | $500 | 468% |
| Imagine 360 Contracted [320494] | $500 | 468% |
| Healthlink Contracted [320179] | $536 | 502% |
| Federal Medical Center Contracted [320127] | $536 | 502% |
| Preferred Health Plan Contracted [320522] | $536 | 502% |
| Compcare Of The Ozarks Contracted [320437] | $564 | 528% |
| Workers Comp [20426] | $571 | 535% |
| Private Health Care Systems Contracted [320320] | $660 | 618% |
| Multiplan [20270] | $678 | 635% |
| Multiplan Contracted [320270] | $678 | 635% |
Consumer Guidance & Cost Commentary
For a lower back X-ray at Mercy Specialty Hospital Southeast Kansas, the cash median rate is $464, which is lower than the facility's gross charge of $714 and significantly below the state average of $138 for the median negotiated rate. This price transparency data indicates that paying out-of-pocket may offer a more affordable option compared to insurance reimbursement, as the cash price is lower than the median negotiated amount of $138 and the median paid amount of $97. Patients with high-deductible plans should consider that while insurance often covers the negotiated rate, the cash price could be cheaper if their deductible has not yet been met or if the insurer's allowed amount exceeds the cash-pay figure.
It is important to note that while the Medicare amount for this procedure is $106.81, the facility's negotiated rates vary widely among payers, ranging from $33 to $678, with Blue Cross Blue Shield having a high of $201 and UnitedHealthcare reaching $660. Because the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should verify their network status before scheduling to avoid unexpected bills. If you are not in-network, you may be subject to balance billing for the difference between the facility's chargemaster rate and the amount your insurer pays, so it is advisable to request an itemized billing audit to identify any errors or unbundled codes before signing consent waivers. Additionally, patients should ask the hospital about prompt-pay discounts, which can reduce the cash price of $464 if paid in full upfront, ensuring you receive the most favorable rate available.