X-ray, lower back
Facility: Trego County Lemke Memorial Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $339
- Cash Discount Price: $361
- vs. Medicare Baseline: 3.17x 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 317% of the Medicare baseline (a markup of 217%). 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 |
|---|---|---|
| Humana | $208 | 195% |
| Tricare | $225 | 211% |
| UnitedHealthcare | $264 - $425 | 247% |
| Medicaid / KanCare | $264 - $425 | 247% |
| Va Ccn - All Plans | $264 | 247% |
| Aetna | $264 - $382 | 247% |
| Ambetter / Centene | $290 | 272% |
| Blue Cross Blue Shield | $339 | 317% |
| Health Partners - All Plans | $404 | 378% |
| Healthy Blue Mcaid - All Plans | $425 | 398% |
Consumer Guidance & Cost Commentary
For the X-ray, lower back procedure (CPT 72110) at Trego County Lemke Memorial Hospital, the cash price of $361.00 is lower than the facility's negotiated rates with most major payers, which range from $264 to $425. While the facility is a Critical Access Hospital in Wakeeney, KS, and is government-owned, the cash median of $361.00 is notably higher than the state average for this service, which is approximately $234.00. Patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price directly, as the insurance negotiated rates for many plans exceed the cash amount. To secure the lowest possible cost, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill.
It is important to understand that the gross charge of $425.00 listed for this service is not the amount you will pay; commercial insurance contracts cap payments at negotiated rates, which are often higher than cash prices due to administrative costs and contract dynamics. If you are billed for the difference between your insurance allowed amount and the cash price, this is known as balance billing, though federal protections like the No Surprises Act may limit these charges for out-of-network providers at in-network facilities. Furthermore, if you receive a summary bill, you should request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected. Comparing your specific situation to the Medicare