X-ray, lower back
Facility: Girard Medical Center
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $210
- Cash Discount Price: $360
- vs. Medicare Baseline: 1.97x 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 |
|---|---|---|
| Humana | $210 | 197% |
| Aetna | $210 - $1,050 | 197% |
| UnitedHealthcare | $210 - $570 | 197% |
| Ambetter / Centene | $210 | 197% |
| Blue Cross Blue Shield | $210 - $248 | 197% |
| Medicare (plans) | $210 | 197% |
| Kansas Superior Select-All Plans | $210 | 197% |
| Multiplan-All Plans | $555 | 520% |
| Uhhis-All Plans | $570 | 534% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Girard Medical Center in Kansas, the facility's cash median rate is $360.00, while the median negotiated rate for in-network payers is $210.00. It is important to note that for patients with high-deductible plans, paying the cash price of $360.00 upfront can sometimes be more cost-effective than relying on insurance, as the insurer's negotiated rate of $210.00 may still exceed the patient's out-of-pocket maximum if their deductible has not been met. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full before or shortly after the service, bypassing the administrative costs associated with insurance claims processing.
The Medicare benchmark for this service is $106.81, which serves as the objective baseline for evaluating pricing markups. While commercial negotiated rates often average 200% to 300% of the Medicare rate, the facility's specific negotiated amount of $210.00 represents a 1.96x multiplier relative to Medicare, aligning closely with the fair pricing range of 120% to 150% when adjusted for local economic factors. This data reflects the specific contract dynamics between the hospital district and various insurers, including Humana, Aetna, and UnitedHealthcare, rather than a state-wide average, highlighting the importance of verifying individual plan allowances before scheduling to avoid unexpected balance billing or underpayment issues.