X-ray, lower back
Facility: Scott County Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $494
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 4.63x 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 463% of the Medicare baseline (a markup of 363%). 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 |
|---|---|---|
| UnitedHealthcare | $60 - $522 | 56% |
| Humana | $231 | 216% |
| Blue Cross Blue Shield | $248 | 232% |
| Wppa | $329 - $1,200 | 308% |
| Aetna | $494 | 463% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Scott County Hospital, the Medicare benchmark rate is $106.81, which serves as the objective baseline for evaluating pricing markups. The facility's negotiated rates range from $231 to $1,200 across five payers, with a median negotiated amount of $494. While the facility is a Critical Access Hospital in Scott City, KS, the data provided does not include specific county or state average figures for comparison. However, it is important to note that commercial negotiated rates often exceed the Medicare rate due to administrative costs and contract structures, with fair pricing typically defined as 120% to 150% of the Medicare amount. In this case, the highest negotiated rate of $1,200 significantly exceeds the 120% to 150% fair pricing range relative to Medicare, highlighting the variability in payer contracts.
Patients should be aware that cash-pay options may offer a lower total cost than insurance claims, particularly for those with high-deductible plans where the insurance negotiated rate exceeds the cash price. Although the cash median is not available in the current data, patients are encouraged to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce bills by 20% to 50% when paid upfront. Additionally, if a patient receives an itemized bill, they should request a full line-by-line statement to identify any errors, double-billing, or unbundled codes, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.