CMS Price Transparency Data

X-ray, lower back

Facility: Atlantic Rehabilitation Institute, LLC

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $597
  • Cash Discount Price: $597
  • vs. Medicare Baseline: 5.59x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Atlantic Rehabilitation Institute, LLC is $597. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $597. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.59x the Medicare baseline. Located in 200 Madison Ave, Madison, NJ.
Cash / Self-Pay
$597

Average discount available for prompt cash payment at this facility.

Insurance Median
$597

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: $597 (559%)
Insurance Median: $597 (559%)
Cash: $597 (559% of Medicare)
Ins. Median: $597 (559% 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 559% of the Medicare baseline (a markup of 459%). 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
Aetna $597 559%
All Savers Cpd $597 559%
Ama Insurance Msg $597 559%
Ambetter / Centene $597 559%
Amerigroup Mgg (Wellpoint As Of 5/1/24) $597 559%
Amerihealth Cpd $597 559%
Amerihealth Mgg $597 559%
Blue Cross Blue Shield $597 559%
Braven Health Cpd $597 559%
Braven Health Mgd $597 559%
Cigna $597 559%
Claim Doc Llc Cpd $597 559%
First Managed Care Wc Cpd $597 559%
Gateway Mgg $597 559%
Medicaid / KanCare $597 559%
Oscar Health Cpd $597 559%
Oxford Health Plan Cpd $597 559%
Oxford Mgg $597 559%
Qualcare Cpd $597 559%
Qualcare Lynx Wc Cpd $597 559%
UnitedHealthcare $597 559%
Upmc For Life Mgg $597 559%
Wellcare Mgg $597 559%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Madison Ave, Madison, NJ 07940
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL