CMS Price Transparency Data

X-ray, lower back

Facility: Southern Ocean Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $199
Cash Discount Price: $116
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Southern Ocean Medical Center is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.86x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$116

Average discount available for prompt cash payment at this facility.

Insurance Median

$199

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: $116 (109%)

Insurance Median: $199 (186%)

Cash: $116 (109% of Medicare)

Ins. Median: $199 (186% 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
Karna	$22 - $96	21%
UnitedHealthcare	$69 - $295	65%
Amerihealth	$99 - $101	93%
Aetna	$103 - $798	96%
Blue Cross Blue Shield	$116	109%
Wellcare	$116	109%
Vaccn	$116	109%
United Community/Americhoice	$122	114%
Cigna	$137 - $815	128%
Clover	$183	171%
Seoul Medical Group	$209	196%
Oxford	$295 - $551	276%
Horizon	$663 - $932	621%
Bergen Risk	$764	715%
Brighton Health Plan	$815	763%
Multiplan - PHCS	$866	811%
Qualcare	$925	866%

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 $116.
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 Southern Ocean Medical 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.