CMS Price Transparency Data

X-ray, lower back

Facility: Sanford Wheaton Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $583
  • Cash Discount Price: $547
  • vs. Medicare Baseline: 5.46x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Sanford Wheaton Medical Center is $583. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $547. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.46x the Medicare baseline. Located in 401 12Th Street North, Wheaton, MN.
Cash / Self-Pay
$547

Average discount available for prompt cash payment at this facility.

Insurance Median
$583

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: $547 (512%)
Insurance Median: $583 (546%)
Cash: $547 (512% of Medicare)
Ins. Median: $583 (546% 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 546% of the Medicare baseline (a markup of 446%). 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.

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
Ucare $112 - $601 105%
Blue Cross Blue Shield $166 - $633 155%
Sanford Health Plan Align $345 323%
Aetna $373 - $594 349%
Health Partners $373 - $554 349%
Medicare (plans) $373 349%
UnitedHealthcare $373 - $571 349%
Security Health Plan $376 352%
Primewest $381 - $414 357%
Sanford Health Plan $540 - $635 506%
Medica $601 - $647 563%
First Choice Health Network $616 577%
Healthez $616 577%
Multiplan $616 577%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 401 12Th Street North, Wheaton, MN 56296
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals