X-ray, lower back
Facility: Clara Barton Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $378
- Cash Discount Price: $294
- vs. Medicare Baseline: 3.54x 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 354% of the Medicare baseline (a markup of 254%). 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 | $246 | 230% |
| 6 Degrees Health - All Plans | $294 | 275% |
| Wppa-All Plans | $336 | 315% |
| Aetna | $378 | 354% |
| UnitedHealthcare | $378 | 354% |
| Phcs - All Plans | $378 | 354% |
| Hlth Partners Of Ks-All Plans | $386 | 361% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Clara Barton Hospital in Hoisington, KS, the facility's cash price of $294.00 is notably lower than the median negotiated rate of $378.00 paid by insurers like Blue Cross Blue Shield and Aetna. This price difference highlights a common billing scenario where paying out-of-pocket can be more cost-effective than relying on insurance, particularly for patients with high deductibles who may face higher out-of-pocket costs if their plan's negotiated rate exceeds the cash price. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
When evaluating this charge against broader benchmarks, it is important to compare rates to the Medicare amount of $106.81 rather than the hospital's gross charge of $420.00, as Medicare rates represent the scientifically validated "true cost" of care under the CMS Prospective Payment System. The facility's cash rate of $294.00 is approximately 2.75 times the Medicare benchmark, which falls within the typical range where commercial rates are marked up significantly above the federal baseline. Consumers should be aware that summary bills often obscure individual line items, so requesting a full itemized statement is essential to identify any unbundled codes or services not rendered. If a patient receives a balance bill from an out-of-network provider at this in-network facility, they may be entitled to protections under the No Surprises Act, which bans balance