CMS Price Transparency Data

X-ray, lower back

Facility: Boston Children's Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $521
Cash Discount Price: $734
vs. Medicare Baseline: 4.88x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Boston Children's Hospital is $521. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $734. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.88x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$734

Average discount available for prompt cash payment at this facility.

Insurance Median

$521

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: $734 (687%)

Insurance Median: $521 (488%)

Cash: $734 (687% of Medicare)

Ins. Median: $521 (488% 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 488% of the Medicare baseline (a markup of 388%). 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
Blue Cross Blue Shield	$232 - $485	217%
Unicare	$245	229%
Cdphp	$360 - $624	337%
Harvard Pilgrim	$373 - $496	349%
United	$439 - $613	411%
Aetna	$440 - $615	412%
Mgb/Allways	$446 - $543	418%
Tufts Public Plan	$451 - $452	422%
United Ri Nj Ny	$462	433%
Ambetter / Centene	$464	434%
Carelon Strategies/Bhs	$477	447%
UnitedHealthcare	$477 - $624	447%
Carelon/Beacon	$550	515%
Fallon	$560 - $566	524%
Health New England	$593	555%
Cigna	$624 - $662	584%
Ets/Lifetrac	$624	584%
Interlink Transplant	$624	584%
Community Health Options	$661	619%
Humana	$661	619%
Coventry/Hcvm/First Health	$675	632%
Multiplan/Phcs	$675 - $697	632%

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 $734.
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 Boston Children's Hospital 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.