CMS Price Transparency Data

X-ray, lower back

Facility: Transylvania Regional Hospital, Inc

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $345
Cash Discount Price: $842
vs. Medicare Baseline: 3.23x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Transylvania Regional Hospital, Inc is $345. 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 3.23x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.

Cash / Self-Pay

$842

Average discount available for prompt cash payment at this facility.

Insurance Median

$345

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: $345 (323%)

Cash: $842 (788% of Medicare)

Ins. Median: $345 (323% 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 323% of the Medicare baseline (a markup of 223%). 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	$159 - $168	149%
United	$161 - $379	151%
Wellcare	$164	154%
Amerihealth	$165	154%
Partners Health Management	$167	156%
Vaya Health	$167	156%
Apex Health	$168	157%
Aetna	$219 - $609	205%
Cigna	$308 - $429	288%
Amerihealth Caritas	$345	323%
Caresource	$370	346%
Medcost	$471 - $716	441%
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

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $842.
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 Transylvania Regional 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.