X-ray, lower back
Facility: Memorial Hospital
Billing Code: 72110 (CPT)
- CPT Billing Code: 72110
- Insurance Median: $557
- Cash Discount Price: $1,013
- vs. Medicare Baseline: 5.21x 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 521% of the Medicare baseline (a markup of 421%). 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 | $262 | 245% |
| Tricare | $506 | 474% |
| Humana | $506 | 474% |
| Medicare (plans) | $511 | 478% |
| Ambetter / Centene | $557 | 521% |
| Coventry - All Other Plans | $912 | 854% |
| Preferred Healthcare-All Plans | $962 | 901% |
| Health Partners Of Kansas - All Plans | $962 | 901% |
| Wppa/Providers Care-All Plans | $1,418 | 1328% |
Consumer Guidance & Cost Commentary
For the CPT code 72110 (X-ray, lower back) at Memorial Hospital in Abilene, KS, the cash price is $1,013.00, which matches the facility's gross chargemaster rate. While commercial insurance negotiated rates for this service range from $262 to $1,418 depending on the payer, the cash price is notably higher than the median negotiated rate of $557.00. This suggests that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price directly could result in lower total costs compared to using insurance, provided the insurance allowed amount exceeds the cash rate. Patients should verify their specific plan's deductible status and consider requesting a "self-pay" or "prompt-pay" discount from the hospital before scheduling, as these upfront payment incentives can significantly reduce the final bill.
The facility's pricing is evaluated against the Medicare benchmark, which serves as a scientifically validated baseline for healthcare costs. For this procedure, the Medicare amount is $106.81, and the commercial cash price is approximately 9.5 times higher than this federal rate. While the data does not provide specific county or state average comparisons for this exact code, the significant markup relative to the Medicare rate highlights the importance of understanding the true cost of care rather than relying on the hospital's full list price. Consumers are advised to request an itemized billing audit if they receive a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Furthermore, under the No Surprises Act, patients are protected from balance billing for out-of