X-ray, lower back
Facility: Fredonia Regional Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $345
- Cash Discount Price: $383
- vs. Medicare Baseline: 3.23x 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 323% of the Medicare baseline (a markup of 223%). 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 | $189 - $248 | 177% |
| Aetna | $195 - $345 | 183% |
| Veterans Programs - All Plans | $195 | 183% |
| UnitedHealthcare | $195 - $345 | 183% |
| Cigna | $345 | 323% |
| Reserve National-All Plans | $345 | 323% |
| Meritain-All Plans | $345 | 323% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Fredonia Regional Hospital in Kansas, the cash price is $383.00, which matches the facility's median negotiated rate and the cash median. This rate is significantly higher than the Medicare benchmark of $106.81, reflecting a markup of 3.2 times the federal baseline. While commercial payers like Blue Cross Blue Shield and Aetna have negotiated rates ranging from $189 to $345, these amounts often exceed the cash price for patients with high-deductible plans. Because insurance administrative structures can inflate the baseline price by 20% to 40%, paying cash upfront may result in lower out-of-pocket costs compared to using an in-network plan where the deductible has not yet been met.
Patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payment and bypass costly claims processing fees. Although the facility is a Critical Access Hospital in a government-owned setting, the gross charge of $383.00 serves as the starting point for any negotiation. To ensure accuracy, consumers should request a full itemized billing audit rather than accepting summary bills, as over 80% of hospital invoices contain errors such as unbundled codes or services not rendered. Comparing this specific rate to state or county averages is essential, as the $383.00 cash price represents the most transparent baseline for evaluating the facility's pricing relative to the local market.