X-ray, lower back
Facility: Graham County Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $247
- Cash Discount Price: $310
- vs. Medicare Baseline: 2.31x 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 231% of the Medicare baseline (a markup of 131%). 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 |
|---|---|---|
| UnitedHealthcare | $145 - $294 | 136% |
| Medicaid / KanCare | $145 | 136% |
| Medicare (plans) | $232 | 217% |
| Blue Cross Blue Shield | $246 | 230% |
| Celtic Commercial-All Other Plans | $256 | 240% |
| Wppa (Providers Care)-All Plans | $294 | 275% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Graham County Hospital in Hill City, KS, the cash price is $310.00, which matches the facility's median negotiated rate of $256.00 and the cash median. While the hospital's negotiated rate of $247.00 is lower than the gross charge of $310.00, it is important to note that commercial rates often exceed the Medicare benchmark of $106.81 for this service. Under Medicare benchmarking principles, fair pricing is typically defined as 120% to 150% of the Medicare rate, whereas commercial rates can average 200% to 300% of that baseline. For patients with high-deductible plans, paying the cash price of $310.00 upfront may be more cost-effective than using insurance, as the insurer's negotiated rate could result in higher out-of-pocket costs if the patient has not yet met their deductible.
Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to verify that all ancillary services, such as lab work or emergency physician services, are also covered under the facility's network agreements. To ensure accuracy, consumers should request a full itemized billing audit rather than accepting summary bills, as over 80% of hospital bills contain errors such as double