CMS Price Transparency Data

X-ray, lower back

Facility: Highlands Arh Regional Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $278
Cash Discount Price: $574
vs. Medicare Baseline: 2.60x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Highlands Arh Regional Medical Center is $278. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $574. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.60x the Medicare baseline. Located in 5000 Kentucky Route 321, Prestonsburg, KY.

Cash / Self-Pay

$574

Average discount available for prompt cash payment at this facility.

Insurance Median

$278

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $574 (537%)

Insurance Median: $278 (260%)

Cash: $574 (537% of Medicare)

Ins. Median: $278 (260% of 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 260% of the Medicare baseline (a markup of 160%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$35 - $278	33%
Blue Cross Blue Shield	$79 - $634	74%
Humana	$79 - $286	74%
UnitedHealthcare	$79 - $426	74%
Wellcare Of Kentucky	$79	74%
Passport Molina	$283	265%
Caresoure Kentucky	$574	537%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $574.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Highlands Arh Regional Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72110.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.