CMS Price Transparency Data

X-ray, lower back

Facility: Phelps Memorial Health Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $278
Cash Discount Price: $317
vs. Medicare Baseline: 2.60x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Phelps Memorial Health Center is $278. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $317. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.60x the Medicare baseline. Located in 1215 Tibbals St, Holdrege, NE.

Cash / Self-Pay

$317

Average discount available for prompt cash payment at this facility.

Insurance Median

$278

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: $317 (297%)

Insurance Median: $278 (260%)

Cash: $317 (297% of Medicare)

Ins. Median: $278 (260% 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 260% of the Medicare baseline (a markup of 160%). 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	$12 - $629	11%
Good Samaritan Mcr Adv - All Plans	$12 - $285	11%
Medica Mcr Adv	$12 - $285	11%
UnitedHealthcare	$12 - $642	11%
Va Ccn - All Plans	$12 - $285	11%
Wellcare Mcr Adv - All Plans	$12 - $285	11%
Three Rivers - All Plans	$14 - $342	13%
Aetna	$15 - $610	14%
Providrs Care/Wppa - All Plans	$16 - $596	15%
Ambetter / Centene	$18 - $740	17%
Provider Network Of American - All Plans	$18 - $616	17%
Partners Hlth Alliance - All Plans	$21 - $530	20%
6 Degrees Hlth - All Plans	$22 - $530	21%
Medica-All Other Plans	$22 - $622	21%
Midwest Ntwrk Alliance - All Plans	$23 - $629	22%
First Health - All Plans	$40 - $630	37%
Molina Mcaid - All Plans	$42 - $291	39%
Cpi Benefit Group-All Plans	$596	558%
Chi Health Partners - All Plans	$629	589%

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 $317.
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 Phelps Memorial Health 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.