X-ray, lower back
Facility: Clay County Medical Center
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $30
- Cash Discount Price: $226
- vs. Medicare Baseline: 0.28x 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.
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 |
|---|---|---|
| Multiplan- All Plans | $12 - $399 | 11% |
| UnitedHealthcare | $18 - $399 | 17% |
| Wppa/Providrs Care- All Plans | $29 - $391 | 27% |
| Aetna | $29 - $391 | 27% |
| Health Partners - All Plans | $30 - $399 | 28% |
Consumer Guidance & Cost Commentary
For the X-ray of the lower back at Clay County Medical Center in Clay Center, KS, the cash price is $226.00, which matches the facility's cash median. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that insurance negotiated rates can sometimes exceed the cash price. For instance, UnitedHealthcare and Multiplan-All Plans have negotiated rates ranging from $18 to $399, meaning a patient with a high-deductible plan might save money by paying the full $226.00 cash rather than relying on insurance, which could result in a higher allowed amount. It is always advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final cost.
The facility's pricing is also contextualized by the Medicare benchmark, which stands at $106.81 for this service. The cash price of $226.00 represents a 2.1x markup over the Medicare rate, a figure that is higher than the typical fair pricing range of 1.2x to 1.5x but lower than the common commercial average of 2x to 3x. Additionally, the median amount paid by insurers is $130.00, which is significantly lower than the cash price, suggesting that for those with active coverage, the insurance process may result in a lower out-of-pocket expense than paying cash. However, if a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they could face balance billing for the difference between the allowed amount and the full chargemaster rate,