CMS Price Transparency Data

X-ray, lower back

Facility: Licking Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $899
  • Cash Discount Price: $1,100
  • vs. Medicare Baseline: 8.42x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Licking Memorial Hospital is $899. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,100. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.42x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$1,100

Average discount available for prompt cash payment at this facility.

Insurance Median
$899

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: $1,100 (1030%)
Insurance Median: $899 (842%)
Cash: $1,100 (1030% of Medicare)
Ins. Median: $899 (842% 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 842% of the Medicare baseline (a markup of 742%). 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
Tricare $99 93%
Aetna $101 - $908 95%
Blue Cross Blue Shield $101 - $945 95%
Champva [500001] $101 95%
Cigna $101 - $990 95%
Humana $101 - $1,067 95%
Medicare (plans) $101 95%
UnitedHealthcare $101 - $935 95%
Veterans Administration [100068] $101 95%
Wellcare By Allwell [450104] $101 95%
Molina Marketplace [100106] $161 151%
Medical Mutual [100114] $605 - $913 566%
Medben [700068] $770 - $1,078 721%
Benicomp [70090] $825 772%
Consociate Health 6 Degrees [100059] $880 824%
Consociate Health [100029] $880 824%
Allied Benefit Systems [100015] $899 842%
Geha [100039] $899 842%
Gravie Administrative Services [100165] $899 842%
Meritain [100063] $899 842%
Optima [700069] $899 842%
Trustmark Small Business Benefits [100263] $899 842%
Webtpa [100127] $899 842%
Healthscope [100157] $935 875%
Surest [100016] $935 875%
United Medical Resources [700071] $935 875%
American Postal Workers [100089] $990 927%
Antidote Health Plan Of Ohio [70006803] $990 927%
Coresource [100002] $990 - $1,100 927%
Great West Life [700064] $990 927%
National Association Of Letter Carriers [100067] $990 927%
Ohio Healthy Luminare Health [100264] $990 927%
Ohio Healthy [100255] $990 927%
Ohio Ppo Connect [70006801] $990 927%
Osu Prime Care [100254] $990 927%
Quality Care Partners [70006802] $990 927%
The Health Plan [100261] $990 927%
Wellfleet Group, Llc [100164] $990 927%
Coventry [100010] $1,015 950%
Pan American Life [700070] $1,015 950%
Ohio Health Choice [100109] $1,056 989%
Administrative Concepts [100006] $1,067 999%
Carefactor [100087] $1,067 999%
Philadelphia American Life [100260] $1,067 - $1,100 999%
Reliance Standard-Asrm [100258] $1,067 999%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals