CMS Price Transparency Data

X-ray, lower back

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $54
Cash Discount Price: $411
vs. Medicare Baseline: 0.51x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Munson Healthcare Otsego Memorial Hospital is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $411. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.51x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$411

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

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: $411 (385%)

Insurance Median: $54 (51%)

Cash: $411 (385% of Medicare)

Ins. Median: $54 (51% 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.

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	$8 - $302	7%
Mclaren Health Plan	$8 - $406	7%
Meridian	$8 - $54	7%
Molina	$8 - $112	7%
Priority Health	$8 - $130	7%
UnitedHealthcare	$8 - $388	7%
Blue Care Network	$12 - $104	11%
Hap (Health Alliance Plan)	$12 - $387	11%
Humana	$12 - $104	11%
Medicare (plans)	$12 - $104	11%
Michigan Amish Medical Board	$12 - $104	11%
Northern Michigan Mennonite Group	$12 - $104	11%
Aetna	$13 - $392	12%
Asr Physicians Care Network	$19 - $387	18%
Cigna	$19 - $130	18%
Nomi Health	$20 - $387	19%
Employee Benefit Logistics	$21 - $177	20%
Munson Hospice	$242 - $852	227%
Hospice Of Michigan	$290	272%
Enterprise Group Planning/Employee Benefit Plan	$387	362%
Cofinity	$411	385%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$411	385%
Three Rivers Provider Network	$411	385%

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 $411.
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 Munson Healthcare Otsego Memorial 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.