X-ray, lower back
Facility: Stafford County Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $416
- Cash Discount Price: $416
- vs. Medicare Baseline: 3.89x 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 389% of the Medicare baseline (a markup of 289%). 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 |
|---|---|---|
| Health Partners-All Plans | $395 | 370% |
| Humana | $416 | 389% |
| Va Ccn-All Plans | $416 | 389% |
| Medica Mcr- All Plans | $416 | 389% |
| UnitedHealthcare | $416 | 389% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Stafford County Hospital in Stafford, KS, the facility's cash and negotiated rates are identical at $416.00, which matches the median paid amount. This rate is significantly higher than the Medicare benchmark of $106.81, reflecting a markup of 390% above the federal baseline. While the facility is a Critical Access Hospital with government-local ownership, the pricing structure suggests that commercial insurance contracts may not offer a lower rate than paying cash directly. Patients with high-deductible plans might find it financially advantageous to pay the $416.00 cash price upfront, as this avoids potential deductibles and avoids the administrative overhead often embedded in commercial negotiated rates.
To secure the best possible price, patients should verify if the hospital offers self-pay or prompt-pay discounts before scheduling, as these incentives can reduce the final bill by 20% to 50%. It is important to note that even though the facility is in-network for payers like Health Partners and Humana, the negotiated rate of $416.00 does not appear to be lower than the cash price, meaning the "in-network" status does not guarantee a reduced cost in this specific instance. Consumers should request an itemized billing audit to ensure no errors exist and should avoid signing consent waivers that could inadvertently waive protections against balance billing, although the No Surprises Act generally shields patients from surprise bills at in-network facilities.