CMS Price Transparency Data
X-ray, lower back
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 72110 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72110
- Insurance Median: $12
- Cash Discount Price: $402
- vs. Medicare Baseline: 0.11x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Saint Alphonsus Medical Center Ontario is $12. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $402. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.11x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$402
Average discount available for prompt cash payment at this facility.
Insurance Median
$12
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: $402 (376%)
Insurance Median: $12 (11%)
Cash: $402 (376% of Medicare)
Ins. Median: $12 (11% 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.
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 |
|---|---|---|
| Medicaid / KanCare | $8 - $185 | 7% |
| Aetna | $10 - $585 | 9% |
| Ambetter / Centene | $10 - $185 | 9% |
| Amish Mennonite | $10 - $185 | 9% |
| Bcccp-Michigan | $10 - $185 | 9% |
| Bccp | $10 - $185 | 9% |
| Blue Cross Blue Shield | $10 - $525 | 9% |
| Bmc Healthnet | $10 - $185 | 9% |
| Breast Grant-Connecticut | $10 - $185 | 9% |
| California Health And Wellness | $10 - $185 | 9% |
| Cardinal Innovations Lme | $10 - $185 | 9% |
| Care Oregon Ohp | $10 - $185 | 9% |
| Cencal Health Plan | $10 - $185 | 9% |
| Cenpatico | $10 - $185 | 9% |
| Chhuny | $10 - $185 | 9% |
| Childrens Comm Health Plan | $10 - $185 | 9% |
| Childrens Medical Services Title 19 | $10 - $185 | 9% |
| Cigna | $10 - $581 | 9% |
| Community Benefit Health | $10 - $185 | 9% |
| Community Care Behavorial Health | $10 - $185 | 9% |
| Community Health Choice | $10 - $185 | 9% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $10 - $185 | 9% |
| Dean Wi Badgercare | $10 - $185 | 9% |
| Delaware First Health | $10 - $185 | 9% |
| Delta Dental Nj | $10 - $185 | 9% |
| Dph Tb Program | $10 - $185 | 9% |
| Dscc | $10 - $185 | 9% |
| Eastpointe Lme | $10 - $185 | 9% |
| Family Health Network | $10 - $185 | 9% |
| Freedom First Healthcare | $10 - $185 | 9% |
| Ghc Scw Wi Badgercare | $10 - $185 | 9% |
| Harbor Health | $10 - $185 | 9% |
| Health Safety Net | $10 - $185 | 9% |
| Healthy Blue Ne | $10 - $185 | 9% |
| Hennepin Health | $10 - $185 | 9% |
| Humana | $10 - $544 | 9% |
| Idaho Womens Health Check | $10 - $185 | 9% |
| Indiana Breast Cervical Cancer | $10 - $185 | 9% |
| Inland Empire Health Plan | $10 - $185 | 9% |
| Intercommunity Health Ohp | $10 - $185 | 9% |
| Iowa Total Care | $10 - $185 | 9% |
| Jai Medical System | $10 - $185 | 9% |
| Kern Family Health Plan | $10 - $185 | 9% |
| Keystone First | $10 - $185 | 9% |
| Keystone First Chip | $10 - $185 | 9% |
| La Care Health Plan | $10 - $185 | 9% |
| Lakeland Care Inc | $10 - $185 | 9% |
| Managed Health Services - Indiana | $10 - $185 | 9% |
| Maryland Breast & Cervical Program | $10 - $185 | 9% |
| Maryland Healthy Smiles - Scion Dental | $10 - $185 | 9% |
| Maryland Physicians Care | $10 - $185 | 9% |
| Massachusetts Behavioral Health Partnership | $10 - $185 | 9% |
| Mdwise | $10 - $185 | 9% |
| Medi-Cal | $10 - $185 | 9% |
| Medi-Cal Healthnet | $10 - $185 | 9% |
| Medstar Dc Healthy Family | $10 - $185 | 9% |
| Medstar Md Health Choice | $10 - $185 | 9% |
| Mo Home State Health Plan | $10 - $185 | 9% |
| Molina Centennial Care | $10 - $185 | 9% |
| Nascentia Health Options | $10 - $185 | 9% |
| Nebraska Total Care | $10 - $185 | 9% |
| New York Cancer Services Program | $10 - $185 | 9% |
| Nextlevel Health | $10 - $185 | 9% |
| Oregon Screenwise | $10 - $185 | 9% |
| Pace Of Southwest Michigan | $10 - $185 | 9% |
| Paramount Advantage | $10 - $185 | 9% |
| Parkland Community Health Plan | $10 - $185 | 9% |
| Partners Behavioral Lme | $10 - $185 | 9% |
| Peach State Healthplan | $10 - $185 | 9% |
| Presbyterian Centennial Care | $10 - $185 | 9% |
| Prestige Health Choice | $10 - $185 | 9% |
| Priority Partners | $10 - $185 | 9% |
| Rx 340B Pass Along | $10 - $185 | 9% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $10 - $185 | 9% |
| Rx Medi-Cal | $10 - $185 | 9% |
| Rx Meridian Rx | $10 - $185 | 9% |
| Sandhills Center Lme | $10 - $185 | 9% |
| Screening For Life | $10 - $185 | 9% |
| Sunshine State Health Plan | $10 - $185 | 9% |
| Superior Health | $10 - $185 | 9% |
| Tenncare | $10 - $185 | 9% |
| Texas Children'S Health Plan | $10 - $185 | 9% |
| Trillium Community Ohp | $10 - $185 | 9% |
| Tufts Health Public Plans | $10 - $185 | 9% |
| UnitedHealthcare | $10 - $593 | 9% |
| Vaya Health Lme | $10 - $185 | 9% |
| Wellsense Health Plan | $10 - $185 | 9% |
| Wi Womens Wellness | $10 - $185 | 9% |
| Align Senior Care | $12 | 11% |
| Ally Align Care Adv | $12 | 11% |
| American Health Advantage Of Idaho | $12 - $127 | 11% |
| American Health Plan | $12 | 11% |
| Aurora Special Needs | $12 | 11% |
| Blue Care Network Advantage | $12 | 11% |
| Blue Shield - De (Highmark) Medciare Advantage | $12 | 11% |
| Care Dimensions | $12 | 11% |
| Care Improvement Plus | $12 | 11% |
| Care Resources Pace | $12 | 11% |
| Careplus Health Plans | $12 | 11% |
| Cca - Zing Health | $12 | 11% |
| Cca Senior Care Options | $12 | 11% |
| Central Valley Medical Services Corp Pace | $12 | 11% |
| Champion Health Plan Mcr Advantage | $12 | 11% |
| Clear Spring Health | $12 | 11% |
| Clover Health | $12 | 11% |
| Commonwealth Care Alliance | $12 | 11% |
| Community Pace At Home | $12 | 11% |
| Eddy Senior Care-Pace | $12 | 11% |
| Eddy Seniorcare Pace | $12 | 11% |
| Elementcare | $12 | 11% |
| Evercare | $12 | 11% |
| Everence | $12 | 11% |
| Gateway Health Plan | $12 | 11% |
| Genesys Pace Of Genesee County | $12 | 11% |
| Georgia Health Advantage | $12 | 11% |
| Gold Advantage | $12 | 11% |
| Gpa Croell Redi Mix | $12 | 11% |
| Health America Advantra | $12 | 11% |
| Highmark Health Options Dual Plan | $12 | 11% |
| Hope Select Pace | $12 | 11% |
| Horizon Nj Total Care | $12 | 11% |
| Hudson Headwaters Pace | $12 | 11% |
| Huron Valley Pace | $12 | 11% |
| Innovative Integrated Health Community Plans | $12 | 11% |
| Iowa Health Advantage | $12 | 11% |
| Johns Hopkins Advantage Md | $12 | 11% |
| Lasso Healthcare Msa | $12 | 11% |
| Life St Marys Pace | $12 | 11% |
| Lifecircles Pace | $12 | 11% |
| Longevity Health Plan | $12 | 11% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $12 | 11% |
| Martins Point Generations Advantage | $12 | 11% |
| Mass General Brigham Mcr Adv | $12 | 11% |
| Medicare (plans) | $12 - $131 | 11% |
| Medipak Advantage | $12 | 11% |
| Mercy Life | $12 | 11% |
| Mercyone Cedar Valley | $12 | 11% |
| Meridian Complete | $12 | 11% |
| Michigan Complete Health | $12 | 11% |
| Nascentia Health Plus | $12 | 11% |
| New Centry Health Careplus | $12 | 11% |
| Osu Prime Care Advantage | $12 | 11% |
| Pace Cny | $12 | 11% |
| Pace Iowa Immanuel Pathways | $12 | 11% |
| Pace Southeast | $12 | 11% |
| Pace-Trinity Health | $12 | 11% |
| Peak Pace Solutions | $12 | 11% |
| Perennial Advantage | $12 | 11% |
| Preferred Care Partners | $12 | 11% |
| Presbyterian Senior Plan | $12 | 11% |
| Provider Partners Health Plan Of Illinois | $12 | 11% |
| Provider Partners Health Plan Of Indiana | $12 | 11% |
| Pruitthealth Premier | $12 | 11% |
| Reliance Community Care Partners Care Resources Pace | $12 | 11% |
| Rx Allwin | $12 | 11% |
| Rx Grane Grnmedd | $12 | 11% |
| Rx Retiree Rx Care | $12 | 11% |
| Scan Health Plan Mcr Ipa Meritage Oon | $12 | 11% |
| Secure Horizons Ma Pffs | $12 | 11% |
| Serenity Pace | $12 | 11% |
| Siouxland Pace | $12 | 11% |
| Solis Health Plans | $12 | 11% |
| Sunnyview-Pace Finance Dept | $12 | 11% |
| Texan Plus | $12 | 11% |
| The Health Plan | $12 | 11% |
| Thome Pace | $12 | 11% |
| Todays Options | $12 | 11% |
| Tribute Health Plans | $12 | 11% |
| Um Health Advantage | $12 | 11% |
| Union Health Service | $12 | 11% |
| Welbe Health | $12 | 11% |
| Wellmed | $12 | 11% |
| Pacificsource Health Plans | $91 - $581 | 85% |
| Selecthealth | $178 - $556 | 167% |
| Ada County Jail Inmate Ins | $185 | 173% |
| Centurion Of Idaho | $185 | 173% |
| Id County Ada | $185 | 173% |
| Id County Canyon | $185 | 173% |
| Id County Cat Fund | $185 | 173% |
| Id County Payette | $185 | 173% |
| Moda Health | $242 - $599 | 227% |
| Blue Benefit Administrators Of Massachusetts | $312 | 292% |
| Blue Care Network | $312 | 292% |
| Blue Distinction Transplant | $312 | 292% |
| Blue Shield - Ca | $312 | 292% |
| Blue Shield - Id (Regence) | $312 | 292% |
| Blue Shield - Ny Highmark Northeastern | $312 | 292% |
| Blue Shield - Ny Highmark Western | $312 | 292% |
| Blue Shield - Pa (Highmark) | $312 | 292% |
| Blue Shield - Wa (Regence) | $312 | 292% |
| Healthcare Management Admin | $321 | 301% |
| Webtpa | $329 - $556 | 308% |
| Mountain Health Co-Op | $371 | 347% |
| Allegiance | $470 | 440% |
| Correctional Health Partners | $482 | 451% |
| Columbia Health Network | $494 | 463% |
| Healthnet | $519 | 486% |
| Allied National Global Care | $556 | 521% |
| Asrm - Reliance Standard Life Insurance | $556 | 521% |
| Christian Care Ministry | $556 | 521% |
| Dean Health | $556 | 521% |
| Fallon Health | $556 | 521% |
| Family Life Insurance Company | $556 | 521% |
| First Choice Health | $556 | 521% |
| Ghc Scw | $556 | 521% |
| International Benefit Administrators | $556 | 521% |
| Lifetime Benefit Solutions | $556 | 521% |
| Manhattan Life | $556 | 521% |
| Pai | $556 | 521% |
| Pan-American Life | $556 | 521% |
| Paramount Hmo | $556 | 521% |
| Phcs | $556 | 521% |
| Trinity Health Share | $556 | 521% |
| Lifewise | $575 | 538% |
| Priority Health | $581 | 544% |
| Allied Benefit Systems | $585 | 548% |
| Ameriben | $585 | 548% |
| Asr Health Benefits | $585 | 548% |
| Christian Brother Services | $585 | 548% |
| Geha | $585 - $593 | 548% |
| Healthez | $585 | 548% |
| Luminare Health (Detroit) | $585 | 548% |
| Rural Carrier Health Benefit Plan | $585 | 548% |
| First Health | $587 | 550% |
| Medi Share | $587 | 550% |
| Providence | $587 | 550% |