CMS Price Transparency Data

X-ray, lower back

Facility: Maimonides Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $20
Cash Discount Price: $150
vs. Medicare Baseline: 0.19x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Maimonides Medical Center is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.19x the Medicare baseline. Located in 4802 Tenth Avenue, Brooklyn, NY.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$20

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: $150 (140%)

Insurance Median: $20 (19%)

Cash: $150 (140% of Medicare)

Ins. Median: $20 (19% 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
Blue Cross Blue Shield	$8 - $141	7%
United Community Plan	$8 - $144	7%
UnitedHealthcare	$8 - $172	7%
Healthfirst	$10 - $128	9%
Emblem Health - Hip	$11	10%
Fidelis	$11 - $14	10%
Healthfirst Early Start	$11	10%
Visiting Nurse Svc Of Ny	$12	11%
Aetna	$14 - $130	13%
Elderplan	$14	13%
Emblem Health - Ghi	$14 - $397	13%
Wellcare	$14	13%
Local 1199	$20 - $47	19%
Cigna	$91	85%
Metroplus	$157	147%
Oxford Health Plan	$172	161%
Oxford Liberty	$172	161%

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 $150.
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 Maimonides 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.