X-ray, lower back
Facility: Hospital District #6 Patterson Health Center
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $288
- Cash Discount Price: $256
- vs. Medicare Baseline: 2.70x 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 270% of the Medicare baseline (a markup of 170%). 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 | $233 - $246 | 218% |
| UnitedHealthcare | $288 - $320 | 270% |
| Providers Care (Wppa)-All Plans | $560 | 524% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back), the facility District #6 Patterson Health Center in Anthony, KS, lists a gross charge of $320.00. The median negotiated rate for in-network payers is $288.00, which aligns with the cash median of $256.00. While the facility is a Critical Access Hospital with government ownership, the data does not provide specific comparative averages against the state or county for this procedure, so no direct comparison to regional pricing benchmarks is available in this report.
Patients should be aware that while insurance plans like Blue Cross Blue Shield and UnitedHealthcare have negotiated rates ranging from $233 to $560 depending on the specific plan, the cash price may offer a lower out-of-pocket cost if you have a high-deductible plan. Since the cash median ($256.00) is lower than the median negotiated rate ($288.00), paying self-pay directly could result in immediate savings. To maximize these savings, you should explicitly request a "self-pay" or "prompt-pay" discount before scheduling your visit and ensure you sign a waiver preventing automatic claims submission to avoid being billed the full negotiated amount.