X-ray, lower back
Facility: Cloud County Health Center
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $962
- Cash Discount Price: $709
- vs. Medicare Baseline: 9.01x 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 901% of the Medicare baseline (a markup of 801%). 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 |
|---|---|---|
| Aetna | $912 - $942 | 854% |
| Pponext-All Plans | $962 | 901% |
| Health Partners - All Plans | $962 | 901% |
| Mpi-All Plans | $962 | 901% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Cloud County Health Center in Concordia, KS, the facility's cash median price is $709.00, which is lower than the state average of $962.00. While the facility's negotiated rates with major payers like Aetna, Pponext-All Plans, and others are set at $962.00, patients with high-deductible plans may find the cash price more advantageous if their insurance allows a higher amount than the cash rate. It is important to note that commercial negotiated rates often include administrative overhead and can exceed cash prices; therefore, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not paying the full negotiated amount.
This service is billed under the Medicare benchmark of $106.81, which serves as the objective baseline for evaluating pricing markups. The facility's cash rate of $709.00 represents a significant markup over the Medicare amount, reflecting the costs of labor, supplies, and facility overhead. Consumers should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, unexpected charges can still occur if ancillary services are out-of-network. To avoid errors or double-billing, patients should request a full itemized CPT-coded bill rather than accepting a summary invoice, and they should verify their deductible status before using insurance to ensure they are not paying out-of-pocket amounts that could be covered by their plan.