CMS Price Transparency Data

X-ray, lower back

Facility: Sanford Worthington Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $270
Cash Discount Price: $392
vs. Medicare Baseline: 2.53x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Sanford Worthington Medical Center is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $392. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.53x the Medicare baseline. Located in 1018 Sixth Avenue Po Box 997, Worthington, MN.

Cash / Self-Pay

$392

Average discount available for prompt cash payment at this facility.

Insurance Median

$270

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: $392 (367%)

Insurance Median: $270 (253%)

Cash: $392 (367% of Medicare)

Ins. Median: $270 (253% 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 253% of the Medicare baseline (a markup of 153%). 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	$81 - $299	76%
Sanford Health Plan Align	$99	93%
Ucare	$106 - $383	99%
Aetna	$107 - $402	100%
Health Partners	$107 - $348	100%
Medicare (plans)	$107	100%
UnitedHealthcare	$107 - $409	100%
Primewest	$110 - $117	103%
Sanford Health Plan	$190 - $223	178%
Security Health Plan	$270	253%
Medica	$437 - $468	409%
First Choice Health Network	$441	413%
Healthez	$441	413%
Multiplan	$441	413%

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 $392.
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 Sanford Worthington 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.