X-ray, lower back
Facility: Rooks County Health Center
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $349
- Cash Discount Price: $291
- vs. Medicare Baseline: 3.27x 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 327% of the Medicare baseline (a markup of 227%). 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 |
|---|---|---|
| Tricare | $182 | 170% |
| Veterans Admin - All Plans | $182 | 170% |
| Celtic Mcr Adv | $182 | 170% |
| Celtic Comm - All Other Plans | $200 | 187% |
| Blue Cross Blue Shield | $248 | 232% |
| Preferred Benefits Admin | $349 | 327% |
| Aetna | $349 | 327% |
| UnitedHealthcare | $349 | 327% |
| Preferred Hlthcare - All Other Plans | $368 | 345% |
| Health Partners - All Plans | $368 | 345% |
| Healthy Blue Mcaid - All Plans | $388 | 363% |
Consumer Guidance & Cost Commentary
For this X-ray of the lower back at Rooks County Health Center in Plainville, Kansas, the facility's cash price of $291.00 is lower than the state average of $349.00 and the county average of $368.00. While many insurance plans negotiate rates that exceed the cash price—ranging from $182 for Tricare to $388 for Healthy Blue Mcaid—paying out-of-pocket may result in a lower total cost for patients with high-deductible plans or those who have already met their coverage limits. Because commercial negotiated rates often include administrative overhead and do not reflect the true cost of care, comparing these figures to the Medicare benchmark of $106.81 reveals significant markups; fair pricing for this service is typically defined as 120% to 150% of the Medicare rate, whereas many commercial contracts approach or exceed 300%.
Patients should proactively contact the hospital to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront fee reductions can further lower the final bill by bypassing costly insurance claims processing. It is also important to request a detailed, itemized billing audit before paying any invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected to reduce debt. If a patient receives a surprise balance bill from an out-of-network provider, they may be entitled to protections under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Always verify your specific plan's deductible status and allowed amount before scheduling to ensure you