X-ray, lower back
Facility: Community Memorial Healthcare, Inc.
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $258
- Cash Discount Price: $469
- vs. Medicare Baseline: 2.42x 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 242% of the Medicare baseline (a markup of 142%). 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 | $216 - $351 | 202% |
| Blue Cross Blue Shield | $248 | 232% |
| UnitedHealthcare | $268 | 251% |
Consumer Guidance & Cost Commentary
For this X-ray of the lower back at Community Memorial Healthcare in Marysville, Kansas, the cash price of $469.00 is significantly higher than the state average, which is approximately $258.00. While the facility's cash rate matches the Medicare benchmark of $106.81 when adjusted for local costs, the actual amount paid by insurance plans varies widely. Aetna plans pay a range between $216 and $351, Blue Cross Blue Shield pays exactly $248, and UnitedHealthcare pays $268. For patients with high-deductible plans, paying the full cash price of $469.00 upfront might be more cost-effective than using insurance, as the negotiated rates for these payers often exceed the cash amount.
Patients should verify their specific plan details before scheduling, as insurance negotiated rates can differ significantly from other in-network providers. Although the facility is a Voluntary non-profit Critical Access Hospital with a 4-star rating, the median amount paid by insurers is only $94.00, which is much lower than the cash price. To potentially lower your bill, you should ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if you pay in full within a short window. Additionally, if you receive an itemized bill, review it carefully for errors or unbundled codes, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.