CMS Price Transparency Data

X-ray, lower back

Facility: Adena Fayette Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $403
Cash Discount Price: $304
vs. Medicare Baseline: 3.77x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Adena Fayette Medical Center is $403. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $304. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.77x the Medicare baseline. Located in 1430 Columbus Avenue, Washington Ch, OH.

Cash / Self-Pay

$304

Average discount available for prompt cash payment at this facility.

Insurance Median

$403

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: $304 (285%)

Insurance Median: $403 (377%)

Cash: $304 (285% of Medicare)

Ins. Median: $403 (377% 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 377% of the Medicare baseline (a markup of 277%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$207 - $423	194%
Aetna	$249 - $482	233%
Buckeye Community Health Plan	$249	233%
Humana	$249	233%
Medical Mutual Of Ohio	$249 - $458	233%
Medigold	$249	233%
Molina	$249	233%
Care Source	$254	238%
Molina Marketplace	$274	257%
United Medical Resources Ohcp	$383	359%
UnitedHealthcare	$383 - $386	359%
Cigna	$419	392%
Ohio Ppo Connect	$426	399%
The Health Plan	$426	399%
Care Source Just4Me	$449	420%
Medical Mutual Of Ohio Supermed	$458	429%
First Health	$477	447%
Ohio Health Choice	$484	453%
Multiplan/Private Healthcare Systems	$578	541%
Sidecar Health	$687	643%

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 $304.
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 Adena Fayette 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.