CMS Price Transparency Data

X-ray, lower back

Facility: Lexington Memorial Hospital Inc

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $291
Cash Discount Price: $330
vs. Medicare Baseline: 2.72x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Lexington Memorial Hospital Inc is $291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $330. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.72x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$330

Average discount available for prompt cash payment at this facility.

Insurance Median

$291

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: $330 (309%)

Insurance Median: $291 (272%)

Cash: $330 (309% of Medicare)

Ins. Median: $291 (272% 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 272% of the Medicare baseline (a markup of 172%). 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
Amerihealth	$124 - $181	116%
Carolina Complete	$124	116%
Healthy Blue	$124	116%
Partners	$124	116%
UnitedHealthcare	$125 - $295	117%
Vaya	$125	117%
Wellcare	$125	117%
Alliance	$127	119%
Trillium	$128	120%
Medcost	$144 - $441	135%
Blue Cross Blue Shield	$179 - $286	168%
Aetna	$187 - $609	175%
Ambetter / Centene	$189	177%
Oscar	$211 - $290	198%
Cigna	$287 - $292	269%
Directnet	$389	364%
Healthgram Lexington Home Brands	$474	444%
Healthgram	$527	493%
Private Healthcare Systems	$540	506%
Beechstreet	$580	543%
Humana	$580	543%
Multiplan	$593	555%
National Provider Network	$593	555%

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 $330.
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 Lexington Memorial Hospital Inc 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.