X-ray, lower back
Facility: Wichita County Health Center
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $477
- Cash Discount Price: $418
- vs. Medicare Baseline: 4.47x 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 447% of the Medicare baseline (a markup of 347%). 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 |
|---|---|---|
| Medicaid / KanCare | $431 | 404% |
| UnitedHealthcare | $523 | 490% |
Consumer Guidance & Cost Commentary
For the X-ray of the lower back at Wichita County Health Center in Leoti, Kansas, the facility's cash price of $418.00 is lower than the median negotiated rate of $477.00 and the gross charge of $523.00. While Medicaid/KanCare and UnitedHealthcare both have a single plan paying the full gross amount of $523.00, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that the facility is a Critical Access Hospital owned by the local government, and while the data does not provide a specific facility rating, consumers should always verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront payment incentives can significantly reduce out-of-pocket costs.
When evaluating the cost relative to federal standards, the Medicare benchmark for this service is $106.81, which serves as the objective baseline for pricing. The facility's cash rate of $418.00 represents a markup of 4.5 times the Medicare amount, which is consistent with the typical range where commercial rates can average 200% to 300% of Medicare, though fair pricing is often defined as 120% to 150%. If you receive an itemized bill, ensure it is not a summary bill that obscures individual charges, and remember that the No Surprises Act protects you from balance billing for emergency care or non-emergency services from out-of-network providers at in-network facilities. Always request a detailed, line-by-line statement to identify any unbundled codes or services