X-ray, lower back
Facility: Hodgeman County Health Center
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $490
- Cash Discount Price: $557
- vs. Medicare Baseline: 4.59x 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 459% of the Medicare baseline (a markup of 359%). 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 | $445 - $661 | 417% |
| Triwest - All Plans | $445 | 417% |
| Medicaid / KanCare | $445 - $696 | 417% |
| Humana | $445 | 417% |
| Aetna | $557 | 521% |
| First Health - All Plans | $626 | 586% |
| Wppa (Provdrscare) - All Plans | $661 | 619% |
| Health Partners - All Plans | $661 | 619% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Hodgeman County Health Center in Jetmore, KS, the facility's cash median rate of $557.00 is significantly lower than the gross charge of $696.00. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare and Medicaid/KanCare have negotiated ranges starting at $445 but extending up to $696, which can be higher than the cash price. This dynamic suggests that patients with high-deductible plans might save money by paying the cash rate directly, provided they verify the facility's "self-pay" or "prompt-pay" discounts before scheduling to avoid unexpected balances.
When evaluating the cost relative to Medicare, the facility's cash rate of $557.00 is 4.6 times higher than the Medicare benchmark of $106.81, which serves as the objective baseline for healthcare delivery costs. Although commercial rates typically average 200% to 300% of Medicare, the specific negotiated amounts for this service vary widely across payers, with some plans like Triwest and Humana settling at the exact cash rate of $445. To ensure you are receiving fair pricing, it is recommended to request an itemized billing audit if you receive a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, if you have out-of-network coverage, the No Surprises Act protects you from balance billing