X-ray, lower back
Facility: Nemaha Valley Community Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $248
- Cash Discount Price: $428
- vs. Medicare Baseline: 2.32x 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 232% of the Medicare baseline (a markup of 132%). 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 |
|---|---|---|
| Va Ccn - All Plans | $209 | 196% |
| Humana | $209 | 196% |
| Aetna | $211 - $404 | 198% |
| Celtic Comm Exch - All Plans | $230 | 215% |
| Partners Direct Health - All Plans | $247 | 231% |
| Blue Cross Blue Shield | $248 | 232% |
| Multiplan - All Plans | $428 | 401% |
| Midlands Choice - All Plans | $451 | 422% |
| Health Partners - All Plans | $451 | 422% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash median rate of $428.00 is significantly lower than the average negotiated rates paid by major insurers like Aetna ($211–$404) and Multiplan ($428). While the hospital's gross charge is $475.00, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, which often results in higher out-of-pocket costs due to deductibles and co-pays. The facility, a voluntary non-profit Critical Access Hospital, offers a cash median that aligns closely with its own negotiated rate of $248.00, suggesting that direct payment avoids the administrative markup typically added by commercial payers.
To minimize unexpected costs, patients should verify their specific plan's allowed amount before scheduling, as commercial rates can vary widely among payers. If you choose to pay out-of-pocket, ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill. Additionally, if you receive a bill from an out-of-network provider or encounter charges for services not rendered, you have the right to request an itemized audit to identify errors such as code unbundling or duplicate charges. Remember that under federal protections like the No Surprises Act, you are generally shielded from balance billing for emergency care at in-network facilities, so do not feel pressured to sign away these rights without fully understanding the terms.