X-ray, lower back
Facility: Wamego Health Center
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $61
- Cash Discount Price: $397
- vs. Medicare Baseline: 0.57x 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.
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 | $10 - $91 | 9% |
| Aetna | $11 - $94 | 10% |
| Medicaid / KanCare | $11 - $94 | 10% |
| Providrs Care | $17 - $64 | 16% |
| Tricare | $71 | 66% |
| Blue Cross Blue Shield | $326 - $343 | 305% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Wamego Health Center in Wamego, KS, the facility's cash median price is $397.00, which is significantly lower than the gross charge of $993.00. While commercial insurance negotiated rates for this service range widely across payers—such as $326 to $343 for Blue Cross Blue Shield and $10 to $91 for UnitedHealthcare—these amounts often exceed the cash price. This is particularly relevant for patients with high-deductible plans, as paying the cash median of $397.00 upfront may result in lower out-of-pocket costs compared to meeting a deductible before insurance coverage kicks in. Additionally, patients should verify if the facility offers self-pay or prompt-pay discounts, which can further reduce the final amount owed by bypassing administrative processing fees.
When evaluating the cost of this procedure, it is important to compare the facility's pricing against the Medicare benchmark, which stands at $106.81. The facility's cash rate of $397.00 represents a markup relative to this federal baseline, illustrating that commercial rates often include additional layers of administrative overhead and contract dynamics not reflected in Medicare reimbursement. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, consumers should avoid assuming that in-network status guarantees the lowest possible price, as negotiated rates vary significantly by payer and can sometimes be higher than the cash option. To ensure transparency, patients are encouraged to request an itemized bill before scheduling and to confirm their deductible status to avoid unexpected balance billing or higher out-of-pocket expenses.