X-ray, lower back
Facility: Mercy Hospital Columbus
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $493
- Cash Discount Price: $441
- vs. Medicare Baseline: 4.62x 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 462% of the Medicare baseline (a markup of 362%). 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 |
|---|---|---|
| Centivo Contracted [320505] | $7 | 7% |
| Humana | $33 - $645 | 31% |
| Medicaid / KanCare | $33 - $493 | 31% |
| Blue Cross Blue Shield | $91 - $493 | 85% |
| UnitedHealthcare | $91 - $564 | 85% |
| Medicare (plans) | $100 - $513 | 94% |
| Health Systems Inc Contracted [320174] | $292 | 273% |
| Insurance System Inc Contracted [320465] | $292 | 273% |
| Administrative Payor Contracted [320005] | $306 | 286% |
| Cherokee Nation Health Serv Contracted [320066] | $493 | 462% |
| Halo Hcr Inc Hospice [20432] | $493 | 462% |
| Aetna | $493 - $611 | 462% |
| Ambetter / Centene | $493 | 462% |
| Halo Hcr Inc Hospice Contracted [320432] | $493 | 462% |
| Mercy Mgd Behavioral Health Contracted [320259] | $493 | 462% |
| Dept Of Veteran Affairs Contracted [320106] | $493 | 462% |
| Provider Partners Health Plans Contracted [320450] | $493 | 462% |
| Mercy Hospice Okc [20252] | $493 | 462% |
| Kindful Hospice Contracted [320434] | $493 | 462% |
| Home State Health Plan Contracted [320187] | $493 | 462% |
| Cigna | $493 | 462% |
| Novasys Contracted [320285] | $493 | 462% |
| Kindful Hospice [20434] | $493 | 462% |
| Centurion Of Missouri [20459] | $493 | 462% |
| Cross Timbers Hospice [20098] | $493 | 462% |
| Elara Caring Aspire Hospice [20433] | $493 | 462% |
| Qual Choice Contracted [320325] | $493 | 462% |
| Pace Of The Ozarks Contracted [320518] | $493 | 462% |
| Indian Health Service Contracted [320198] | $493 | 462% |
| Globalhealth Contracted [320145] | $493 | 462% |
| Medical Associates Health Contracted [320444] | $493 | 462% |
| Tricare | $495 | 463% |
| Healthscope Contracted [320182] | $524 | 491% |
| Workers Comp [20426] | $543 - $577 | 508% |
| United Medical Resources Contracted [320454] | $564 - $645 | 528% |
| Medica Contracted [320239] | $608 | 569% |
| Healthlink Contracted [320179] | $611 - $645 | 572% |
| Preferred Health Plan Contracted [320522] | $611 | 572% |
| Mercy Benefit Admin Contracted [320251] | $611 - $645 | 572% |
| American Healthcare Alliance Contracted [320020] | $611 | 572% |
| Usa Managed Care Org Contracted [320429] | $611 | 572% |
| First Health Contracted [320128] | $611 | 572% |
| Federal Medical Center Contracted [320127] | $611 | 572% |
| Reflect Health Contracted [320492] | $645 | 604% |
| Aither Health Contracted [320449] | $645 | 604% |
| Private Health Care Systems Contracted [320320] | $645 | 604% |
| Ebms Contracted [320493] | $645 | 604% |
| Show-Me Health Administrators Contracted [320483] | $645 | 604% |
| Ppo Plus Contracted [320310] | $645 | 604% |
| Benefit Management Contracted [320052] | $645 | 604% |
| Yuzu Health Contracted [320521] | $645 | 604% |
| 90 Degree Benefits Contracted [320436] | $645 | 604% |
| Auxiant Contracted [320462] | $645 | 604% |
| Point C Contracted [320238] | $645 | 604% |
| Edison Health Solutions Contracted [320502] | $645 | 604% |
| Imagine 360 Contracted [320494] | $645 | 604% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Mercy Hospital Columbus, the facility's cash price of $441.00 is lower than the median negotiated rate of $493.00 paid by most commercial payers. While the gross charge is $679.00, patients with high-deductible plans may find the cash price more affordable if their insurance negotiated rate exceeds this amount. It is important to note that many commercial payers, including Humana and Medicaid/KanCare, have negotiated rates ranging from $33 to $645, which can be significantly higher than the cash price. Patients should verify their specific plan's allowed amount before scheduling, as assuming in-network status guarantees the lowest price is a common pitfall; some in-network facilities charge substantially more than others for the same service.
The facility's cash price of $441.00 is also notably lower than the Medicare benchmark of $106.81 when adjusted for the specific markup context, though the direct comparison shows the cash rate is higher than the base Medicare amount due to the nature of the service and facility costs. Commercial negotiated rates generally average 200% to 300% of Medicare, while fair pricing is typically defined as 120% to 150% of Medicare, suggesting that commercial rates often include significant administrative overhead. To minimize costs, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the billed amount for upfront payment. Additionally, requesting an itemized billing audit is recommended, as over