X-ray, lower back
Facility: F W Huston Medical Center
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $457
- Cash Discount Price: $475
- vs. Medicare Baseline: 4.28x 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 428% of the Medicare baseline (a markup of 328%). 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 | $248 | 232% |
| Aetna | $446 | 418% |
| Humana | $469 | 439% |
| Cigna | $505 | 473% |
Consumer Guidance & Cost Commentary
For the X-ray, lower back procedure (CPT 72110) at F W Huston Medical Center in Winchester, KS, the facility's cash price of $475.00 is notably lower than the negotiated rates charged to major insurers like Aetna ($446), Humana ($469), and Cigna ($505). While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash rate. It is important to note that the facility's cash price is also lower than the state average for this service, making it a potentially economical option for those without comprehensive coverage.
The Medicare benchmark for this procedure is $106.81, which serves as the objective baseline for evaluating pricing fairness; commercial rates are often significantly higher due to administrative costs and contract dynamics. Although the facility offers a median negotiated rate of $457.00, patients should be aware that balance billing can still occur if they receive care from out-of-network providers, even at an in-network hospital, where the provider bills the difference between their full chargemaster and the insurance allowed amount. To avoid unexpected costs, consumers should request a prompt-pay discount before scheduling, which can reduce the bill by 20% to 50% if paid in full upfront, and always demand an itemized bill to verify that no services were unbundled or incorrectly charged.