CMS Price Transparency Data

X-ray, lower back

Facility: Highlands Cashiers Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $376
  • Cash Discount Price: $842
  • vs. Medicare Baseline: 3.52x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Highlands Cashiers Hospital is $376. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $842. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.52x the Medicare baseline. Located in 190 Hospital Drive, Highlands, NC.
Cash / Self-Pay
$842

Average discount available for prompt cash payment at this facility.

Insurance Median
$376

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: $842 (788%)
Insurance Median: $376 (352%)
Cash: $842 (788% of Medicare)
Ins. Median: $376 (352% 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 352% of the Medicare baseline (a markup of 252%). 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
Apex Health $168 157%
Cigna $276 - $374 258%
Blue Cross Blue Shield $287 - $303 269%
United $291 - $510 272%
Wellcare $295 276%
Amerihealth $298 279%
Partners Health Management $301 282%
Vaya Health $301 282%
Amerihealth Caritas $320 300%
Caresource $370 346%
Medcost $395 - $475 370%
Aetna $404 - $612 378%
Magellan $505 473%
Magellan Behavioral Health $505 473%
Multiplan $674 631%
Avalon Administrative Services $716 670%
Prime Health $741 - $758 694%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 190 Hospital Drive, Highlands, NC 28741
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals