X-ray, lower back
Facility: Ashland Health Center
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $345
- Cash Discount Price: $276
- vs. Medicare Baseline: 3.23x 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 323% of the Medicare baseline (a markup of 223%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $115 | 108% |
| Compalliance-All Plans | $276 | 258% |
| Health Partners Of Kansas-All Plans | $293 | 274% |
| Multiplan-All Plans | $338 | 316% |
| Medicare (plans) | $344 | 322% |
| UnitedHealthcare | $344 | 322% |
| Medica Mcare - All Plans | $344 | 322% |
| Aetna | $344 | 322% |
| Medicaid / KanCare | $344 | 322% |
| Health Choice-All Plans | $344 | 322% |
| Healthy Blue Mcr Adv - All Other Plans | $344 | 322% |
| Providers Care (Wppa)-All Plans | $517 | 484% |
Consumer Guidance & Cost Commentary
For the X-ray, lower back procedure (CPT 72110) at Ashland Health Center in Ashland, KS, the facility's cash median rate is $276.00, which is lower than the state average of $345.00. While the facility's negotiated rates with most payers align with the state average, the cash price offers a distinct advantage for patients with high-deductible plans or those seeking to minimize upfront costs. It is important to note that commercial insurance contracts often include administrative overhead and multi-layered pricing structures that can result in negotiated rates exceeding cash prices; therefore, self-pay patients should verify if their specific plan's deductible has been met before assuming insurance will reduce the final bill. Additionally, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the total amount owed by bypassing the costly insurance claims processing cycle.
The facility's Medicare benchmarking rate for this service is $106.81, serving as the objective baseline for evaluating pricing markups. Commercial negotiated rates in this dataset average between 200% and 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of this federal standard. Although the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should remain vigilant regarding balance billing practices, particularly if receiving care from out-of-network providers or ancillary services like emergency physicians. Under the No Surprises Act, balance billing for non-emergency services at in-network facilities is prohibited, and patients should request a formal, itemized billing audit before paying any invoice to ensure