CMS Price Transparency Data

X-ray, lower back

Facility: Hamilton County Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $232
  • Cash Discount Price: $243
  • vs. Medicare Baseline: 2.17x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Hamilton County Hospital is $232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $243. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.17x the Medicare baseline. Located in 700 North Huser Street, Syracuse, KS.
Cash / Self-Pay
$243

Average discount available for prompt cash payment at this facility.

Insurance Median
$232

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $243 (228%)
Insurance Median: $232 (217%)
Cash: $243 (228% of Medicare)
Ins. Median: $232 (217% of 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 217% of the Medicare baseline (a markup of 117%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $117 - $248 110%
First Health Coventry - All Plans $207 194%
Cigna $231 216%
UnitedHealthcare $231 216%
Va Ccn - All Plans $243 228%
Aetna $413 387%

Consumer Guidance & Cost Commentary

For the CPT code 72110 (X-ray, lower back), Hamilton County Hospital in Syracuse, KS, lists a cash price of $243.00, which matches the facility's negotiated median paid amount of $231.00 and the Medicare benchmark of $106.81. While the facility is a Critical Access Hospital with government-local ownership, the cash rate is significantly higher than the Medicare amount, reflecting standard commercial pricing structures. It is important to note that commercial negotiated rates for this service vary widely among payers, ranging from $117 to $413, with Blue Cross Blue Shield offering the lowest range at $117 to $248 across three plans. Patients with high-deductible plans may find the cash price of $243.00 more affordable than the negotiated rates charged by insurers like Aetna ($413) or UnitedHealthcare ($231), provided they have not yet met their out-of-pocket maximum.

To minimize costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees. Since the facility is in-network for several major carriers, balance billing is not expected for the primary service under the No Surprises Act, but patients should still verify their specific plan details to ensure no unexpected ancillary charges apply. If a discrepancy arises, consumers are advised to demand a full itemized billing audit rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 700 North Huser Street, Syracuse, KS 67878
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals