CMS Price Transparency Data

X-ray, lower back

Facility: Helen Newberry Joy Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $33
Cash Discount Price: $21
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Helen Newberry Joy Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.31x the Medicare baseline. Located in 502 W Harrie St, Newberry, MI.

Cash / Self-Pay

$21

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $21 (20%)

Insurance Median: $33 (31%)

Cash: $21 (20% of Medicare)

Ins. Median: $33 (31% 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
Mi Wc - All Plans	$13 - $278	12%
Aetna	$18 - $412	17%
Uphg Tpa - All Plans	$18 - $391	17%
Cigna	$19 - $421	18%
First Health - All Plans	$19 - $412	18%
Health Alliance - All Plans	$19 - $421	18%
Healtheos - All Plans	$19 - $421	18%
Ppom/Cofinity - All Plans	$19 - $412	18%
Priority Health - All Plans	$19 - $421	18%
UnitedHealthcare	$19 - $421	18%
Vital Core - All Plans	$19 - $421	18%
Blue Cross Blue Shield	$20 - $428	19%
Humana	$174 - $321	163%
Mi Health Link - All Plans	$174 - $321	163%
Va - All Plans	$178 - $253	167%
Uphp Mcaid - All Plans	$204 - $229	191%

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 $21.
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 Helen Newberry Joy 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.