X-ray, lower back
Facility: Hiawatha Community Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $592
- Cash Discount Price: $760
- vs. Medicare Baseline: 5.54x 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 554% of the Medicare baseline (a markup of 454%). 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 | $236 - $248 | 221% |
| UnitedHealthcare | $281 - $653 | 263% |
| Aetna | $281 - $614 | 263% |
| Humana | $284 | 266% |
| Ambetter / Centene | $337 | 316% |
| Centrus Health Direct - All Plans | $570 | 534% |
| Oscar - All Plans | $570 | 534% |
| Preferred Hlth - All Plans | $684 | 640% |
| Cigna | $722 | 676% |
| Wppa Providrs Care - All Plans | $722 | 676% |
| Multiplan - All Plans | $737 | 690% |
| Midlands Choice - All Plans | $737 | 690% |
| Healthy Blue Mcaid - All Plans | $760 | 712% |
Consumer Guidance & Cost Commentary
For the X-ray, lower back procedure (CPT 72110) at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $760.00, which matches the facility's gross charge and the state median cash rate. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $236 to $653, these amounts are often higher than the cash price for patients with high-deductible plans. Because insurance billing involves administrative overhead and potential claim denials, paying cash upfront can sometimes result in lower out-of-pocket costs if the negotiated rate exceeds the cash price. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the costly insurance claims cycle and save money on administrative labor.
The facility's negotiated rates are significantly higher than the Medicare benchmark of $106.81, reflecting the standard markup in commercial healthcare pricing where rates often average 200% to 300% of the Medicare amount. Although the median negotiated payment across payers is $592.00, this figure does not represent the lowest possible cost for a patient. To ensure transparency and avoid unexpected balance billing, consumers should request a detailed, itemized bill that breaks down every CPT code and unit cost, as over 80% of hospital bills contain errors such as double-billing or unbundled charges. If a surprise bill arises, patients should dispute it in writing with the billing supervisor rather than paying immediately, and always verify their deductible status before relying on insurance to cover shoppable tests.