CMS Price Transparency Data

X-ray, lower back

Facility: Pender Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $101
Cash Discount Price: $158
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Pender Memorial Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.95x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$158

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $158 (148%)

Insurance Median: $101 (95%)

Cash: $158 (148% of Medicare)

Ins. Median: $101 (95% 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
Blue Cross Blue Shield	$46 - $130	43%
Humana	$90 - $303	84%
Pace Of The Southern Piedmont	$95	89%
Aetna	$97 - $299	91%
New Hanover Health	$97	91%
Cigna	$98 - $155	92%
Carolina Complete	$99	93%
Nc Department Of Public Safety	$99 - $190	93%
Amerihealth	$101	95%
Wellcare	$101	95%
Ambetter / Centene	$133	125%
Liberty Health	$135	126%
Caresource North Carolina	$141	132%
Plotkin Health	$211	198%
UnitedHealthcare	$257	241%
Medcost	$265 - $295	248%
Employers Choice Network	$341	319%
Three Rivers Provider Network	$341	319%

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 $158.
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 Pender Memorial 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.