CMS Price Transparency Data

X-ray, lower back

Facility: Harlem Hospital Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $71
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.66x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Harlem Hospital Center is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.66x the Medicare baseline. Located in 506 Lenox Avenue, New York, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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%)

Insurance Median: $71 (66%)

Ins. Median: $71 (66% 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
Healthfirst	$11 - $161	10%
Aetna	$12 - $1,131	11%
Amidacare	$14 - $71	13%
Emblem	$14 - $96	13%
Wellcare	$15 - $63	14%
Metroplus	$17 - $161	16%
United	$18 - $112	17%
Fidelis	$20 - $179	19%
Oscar	$20 - $189	19%
Blue Cross Blue Shield	$71 - $161	66%
Carelon	$71 - $213	66%
Senior Whole Health	$71	66%
United Behavioral Health	$71 - $79	66%
Affinity	$73 - $161	68%
Carelon (Amida Care)	$73	68%
Vnsny	$73 - $126	68%
Cigna	$96	90%
Oxford	$112	105%
Elderplan	$126	118%
Vaccn	$126	118%
Centers Plan For Healthy Living	$131	123%
Centerlight	$164	154%
Magnacare	$246	230%
Multiplan	$263	246%
Local 1199	$279	261%
Villagecare Max	$279	261%

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 $X.
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 Harlem Hospital 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.