X-ray, lower back
Facility: Morris County Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $318
- Cash Discount Price: $490
- vs. Medicare Baseline: 2.98x 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 298% of the Medicare baseline (a markup of 198%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $46 | 43% |
| Blue Cross Blue Shield | $236 - $318 | 221% |
| UnitedHealthcare | $318 - $816 | 298% |
| Choice Care Mcr Adv-All Plans | $318 | 298% |
| Va Ccn-All Plans | $318 | 298% |
| Coventry Mcr | $318 | 298% |
| Cigna | $590 | 552% |
| Aetna | $731 | 684% |
| Multiplan-All Plans | $734 | 687% |
| Coventry Comm-All Other Plans | $734 | 687% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Morris County Hospital in Council Grove, KS, the facility's cash median price of $490.00 is significantly higher than the state average of $454.00. While the hospital's negotiated rates with major payers like Blue Cross Blue Shield and UnitedHealthcare range from $236 to $816, these amounts often exceed the cash price, making self-pay a potentially more cost-effective option for patients with high-deductible plans. To maximize savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as paying in full upfront can bypass administrative fees and reduce the final bill. It is also important to avoid accepting summary bills; instead, request a detailed itemized statement to verify that no unbundled charges or services not rendered are included in the total.
The facility's billing practices align with federal benchmarks, showing a Medicare comparison ratio of 3.0, which indicates the gross charges are substantially higher than the federal baseline. Under the Medicare benchmarking principle, fair pricing is typically defined as 120% to 150% of the Medicare rate, whereas commercial negotiated rates can average 200% to 300% of that baseline. Given that the Medicare amount for this procedure is $106.81, patients should be aware that the negotiated rates listed for in-network plans reflect complex contract dynamics and administrative costs rather than the true cost of care. If a patient receives an unexpected bill, they should verify the legality of any balance billing under the No Surprises Act, particularly if the care was provided at an