CMS Price Transparency Data

X-ray, lower back

Facility: Guadalupe Regional Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $105
Cash Discount Price: $155
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Guadalupe Regional Medical Center is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $155. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.98x the Medicare baseline. Located in 1215 E Court St, Seguin, TX.

Cash / Self-Pay

$155

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $155 (145%)

Insurance Median: $105 (98%)

Cash: $155 (145% of Medicare)

Ins. Median: $105 (98% 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
Superior Hlth Plan Mmcd	$35 - $254	33%
Aetna	$47 - $480	44%
Christus Exchange Health Plan	$47 - $105	44%
Mcr Clover Health	$47 - $105	44%
Mcr Texas Independence Health	$47 - $105	44%
Mcr Wellcare	$47 - $105	44%
Oscar Health Plan	$47 - $105	44%
Va Triwest Health Alliance	$47 - $105	44%
Healthcare Highways	$58 - $424	54%
UnitedHealthcare	$58 - $424	54%
Humana	$65 - $480	61%
Cigna	$69 - $508	65%
Texas Mutual Insurance Co	$69 - $508	65%
Blue Cross Blue Shield	$343 - $382	321%

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 $155.
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 Guadalupe Regional 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.