CMS Price Transparency Data

X-ray, lower back

Facility: Novant Health Forsyth Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $274
Cash Discount Price: $263
vs. Medicare Baseline: 2.57x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Novant Health Forsyth Medical Center is $274. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $263. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.57x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$263

Average discount available for prompt cash payment at this facility.

Insurance Median

$274

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: $263 (246%)

Insurance Median: $274 (257%)

Cash: $263 (246% of Medicare)

Ins. Median: $274 (257% 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 257% of the Medicare baseline (a markup of 157%). 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	$46 - $376	43%
Carolina Complete	$79 - $102	74%
Nc Department Of Public Safety	$79 - $203	74%
Amerihealth	$81 - $104	76%
UnitedHealthcare	$81 - $368	76%
Wellcare	$81 - $104	76%
Humana	$101 - $426	95%
Pace Of The Southern Piedmont	$101	95%
Aetna	$104 - $438	97%
Cigna	$104 - $325	97%
Liberty Health	$106	99%
Caresource North Carolina	$171 - $219	160%
Atlantic Corporation Dba Atlantic Packaging	$242 - $309	227%
Plotkin Health	$257 - $328	241%
Amps	$278 - $356	260%
Medcost	$364 - $514	341%
Primary Physician Care	$377 - $481	353%
Beechstreet	$385 - $492	360%
Multiplan	$385 - $492	360%
Phcs	$385 - $492	360%
Employers Choice Network	$415 - $531	389%
Three Rivers Provider Network	$415 - $531	389%

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 $263.
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 Novant Health Forsyth 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.