CMS Price Transparency Data
X-ray, lower back
Facility: Trinity Health Muskegon Hospital
Billing Code: 72110 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72110
- Insurance Median: $344
- Cash Discount Price: $298
- vs. Medicare Baseline: 3.22x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Trinity Health Muskegon Hospital is $344. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $298. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.22x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$298
Average discount available for prompt cash payment at this facility.
Insurance Median
$344
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: $298 (279%)
Insurance Median: $344 (322%)
Cash: $298 (279% of Medicare)
Ins. Median: $344 (322% 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 322% of the Medicare baseline (a markup of 222%). 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.
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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 | $58 - $109 | 54% |
| Medicaid / KanCare | $58 - $60 | 54% |
| Access Health | $78 | 73% |
| Bcn Domestic | $107 | 100% |
| Blue Benefit Administrators Of Massachusetts | $107 | 100% |
| Blue Care Network | $107 | 100% |
| Blue Distinction Transplant | $107 | 100% |
| Blue Shield - Ca | $107 | 100% |
| Blue Shield - Id (Regence) | $107 | 100% |
| Blue Shield - Ny Highmark Northeastern | $107 | 100% |
| Blue Shield - Ny Highmark Western | $107 | 100% |
| Blue Shield - Pa (Highmark) | $107 | 100% |
| Blue Shield - Wa (Regence) | $107 | 100% |
| Health Choices | $107 - $362 | 100% |
| Kaiser Domestic | $107 | 100% |
| Aetna | $109 - $193 | 102% |
| Blue Care Network Advantage | $109 | 102% |
| Medicare (plans) | $109 | 102% |
| Align Senior Care | $112 | 105% |
| Correctional Recovery | $112 | 105% |
| Heartland Hospice | $112 | 105% |
| Hospice Harbor Hospice | $112 | 105% |
| U Of M Health Plan | $113 - $362 | 106% |
| UnitedHealthcare | $115 - $404 | 108% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $126 | 118% |
| Geha | $135 - $404 | 126% |
| Meritain | $135 | 126% |
| Oscar | $143 | 134% |
| Molina Marketplace | $145 | 136% |
| Vitalcore | $173 | 162% |
| Wellpath | $173 | 162% |
| Acs Benefit Services | $239 | 224% |
| Allied Benefit Systems | $239 | 224% |
| Claimchoice Adminstrators | $239 | 224% |
| Consociate | $239 | 224% |
| Cypress Benefit Administrators | $239 | 224% |
| Forest County Potawatomi | $239 | 224% |
| Health Smart | $239 | 224% |
| Healthgram | $239 | 224% |
| Healthscope | $239 | 224% |
| Preferred One | $239 | 224% |
| Secureone Preferred United Plans | $239 | 224% |
| Sisco Benefits | $239 | 224% |
| The Health Plan | $239 | 224% |
| Trustmark Small Business Benefits | $239 | 224% |
| Unified Group Services | $239 | 224% |
| Webtpa | $239 | 224% |
| Asr Health Benefits | $244 | 228% |
| Hap | $244 - $364 | 228% |
| Wc Accident Fund | $245 | 229% |
| Wc Advantage | $245 | 229% |
| Wc Aig | $245 | 229% |
| Wc Allied | $245 | 229% |
| Wc Amerisure | $245 | 229% |
| Wc Amtrust | $245 | 229% |
| Wc Asu Risk Mgt | $245 | 229% |
| Wc Berkley Admin | $245 | 229% |
| Wc Broadspire | $245 | 229% |
| Wc Bunch & Associates | $245 | 229% |
| Wc Ccmsi | $245 | 229% |
| Wc Emc Insurance Company | $245 | 229% |
| Wc Esis | $245 | 229% |
| Wc Fcci | $245 | 229% |
| Wc Federated | $245 | 229% |
| Wc Gallagher Bassett | $245 | 229% |
| Wc Genex Care For Ohio | $245 | 229% |
| Wc Guard Insurance Company | $245 | 229% |
| Wc Hartford | $245 | 229% |
| Wc Liberty Mutual | $245 | 229% |
| Wc Meijers | $245 | 229% |
| Wc Michigan | $245 | 229% |
| Wc Mitchell Frankenmuth | $245 | 229% |
| Wc Pma | $245 | 229% |
| Wc Sedgwick | $245 | 229% |
| Wc Sentry | $245 | 229% |
| Wc Travelers | $245 | 229% |
| Wc Tristar | $245 | 229% |
| Wc Walmart | $245 | 229% |
| Wc Zurich | $245 | 229% |
| Hospice Of Michigan | $252 | 236% |
| Nomi Health | $257 | 241% |
| Varipro | $266 | 249% |
| Caresource | $289 | 271% |
| Cigna | $289 | 271% |
| 1199 National Benefit Fund | $344 | 322% |
| Allied National Global Care | $344 | 322% |
| Asrm - Reliance Standard Life Insurance | $344 | 322% |
| Christian Care Ministry | $344 | 322% |
| Dean Health | $344 | 322% |
| Fallon Health | $344 | 322% |
| Family Life Insurance Company | $344 | 322% |
| Ghc Scw | $344 | 322% |
| Group Pension Administrators | $344 | 322% |
| International Benefit Administrators | $344 | 322% |
| Lifetime Benefit Solutions | $344 | 322% |
| Manhattan Life | $344 | 322% |
| Medi Share | $344 | 322% |
| Multiplan | $344 | 322% |
| Mvp | $344 | 322% |
| Pai | $344 | 322% |
| Pan-American Life | $344 | 322% |
| Paramount Hmo | $344 | 322% |
| Phcs | $344 | 322% |
| Trinity Health Share | $344 | 322% |
| Priority Health | $350 - $392 | 328% |
| Acclaim | $362 | 339% |
| Administrative Concepts | $362 | 339% |
| Allegeant | $362 | 339% |
| Ameriben | $362 | 339% |
| American Family | $362 | 339% |
| American Healthcare Alliance | $362 | 339% |
| American Republic | $362 | 339% |
| Amerihealth | $362 | 339% |
| Aultcare | $362 | 339% |
| Automated Benefit Services | $362 | 339% |
| Auxiant | $362 | 339% |
| Benefit Administrative Systems,Llc | $362 | 339% |
| Boon Chapman | $362 | 339% |
| Cam Administrative Services | $362 | 339% |
| Christian Brother Services | $362 | 339% |
| Christian Brothers Holy Cross | $362 | 339% |
| Comprehensive Benefits | $362 | 339% |
| Continental Life Insurance | $362 | 339% |
| Custom Benefit Administrators | $362 | 339% |
| Employee Benefit Concepts | $362 | 339% |
| Employee Benefit Management | $362 | 339% |
| Enterprise Group Planning | $362 | 339% |
| Freedom Life Insurance Company | $362 | 339% |
| Group Administrators | $362 | 339% |
| Group Marketing Services | $362 | 339% |
| Guardian | $362 | 339% |
| Health America | $362 | 339% |
| Healthez | $362 | 339% |
| Humana | $362 | 339% |
| Insight | $362 | 339% |
| Intercare | $362 | 339% |
| Jfp Benefit Management | $362 | 339% |
| Jp Farley Corporation | $362 | 339% |
| Key Benefit Administrator | $362 | 339% |
| Liberty Union Life Assurance Co | $362 | 339% |
| Lucent Health | $362 | 339% |
| Luminare Health | $362 | 339% |
| Luminare Health (Detroit) | $362 | 339% |
| Medben | $362 | 339% |
| Medcost | $362 | 339% |
| Medical Mutual | $362 | 339% |
| Mutual Health Services | $362 | 339% |
| Mutual Of Omaha | $362 | 339% |
| Ncas | $362 | 339% |
| Nippon Life Ins | $362 | 339% |
| Nova | $362 | 339% |
| Painters Union Insurance Fund | $362 | 339% |
| Physicians Mutual | $362 | 339% |
| Plumbers Local 98 Insurance Fund | $362 | 339% |
| Prairie States | $362 | 339% |
| Primary Physician Care | $362 | 339% |
| Professional Benefit Administrators | $362 | 339% |
| The Loomis Company | $362 | 339% |
| Unicare | $362 | 339% |
| Us Health And Life | $362 | 339% |
| Valenz | $362 | 339% |
| Western & Southern Financial Group | $362 | 339% |
| Wps | $362 | 339% |
| First Health | $377 | 353% |
| Barinet | $459 | 430% |
| Cmh Allegan County | $459 | 430% |
| Cmh Barry County | $459 | 430% |
| Cmh Berrien County | $459 | 430% |
| Cmh Cass County | $459 | 430% |
| Cmh Kalamazoo | $459 | 430% |
| Cmh Kent County | $459 | 430% |
| Cmh Misc | $459 | 430% |
| Cmh Muskegon County | $459 | 430% |
| Cmh North Country | $459 | 430% |
| Cmh Northern Lakes County | $459 | 430% |
| Cmh Ottawa County | $459 | 430% |
| Cmh Van Buren County | $459 | 430% |
| Cmh West Mi County | $459 | 430% |