CMS Price Transparency Data

X-ray, lower back

Facility: Medical City Fort Worth

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $175
Cash Discount Price: $1,914
vs. Medicare Baseline: 1.64x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Medical City Fort Worth is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,914. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.64x the Medicare baseline. Located in 900 Eighth Avenue, Fort Worth, TX.

Cash / Self-Pay

$1,914

Average discount available for prompt cash payment at this facility.

Insurance Median

$175

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: $1,914 (1792%)

Insurance Median: $175 (164%)

Cash: $1,914 (1792% of Medicare)

Ins. Median: $175 (164% 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
Amerigroup	$52	49%
Cook Childrens Health Plan	$52	49%
Parkland Community Health Plan	$52	49%
United	$52 - $360	49%
Cigna	$55 - $1,014	51%
Healthspring Life	$55	51%
Aetna	$56 - $1,127	52%
Molina	$57 - $58	53%
Humana	$65 - $132	61%
Blue Cross Blue Shield	$133 - $850	125%
Superior Health Plan	$134	125%
Unicare	$421 - $1,914	394%
Healthcare Highways	$469 - $647	439%
Evry Health	$494	463%
Curative Administrators	$766	717%
City Of Mckinney	$861	806%
Fidelis Securecare	$861	806%
Emerging Therapy Solutions	$957 - $1,378	896%
National Choicecare	$957	896%
Pc Texas Partners	$1,053	986%
Physicians Coop Of Tx	$1,053	986%
Rockport Health Group	$1,053	986%
Averde Health, Inc	$1,110	1039%
Coastal Comp Health Networks	$1,340	1255%
Mega Life	$1,340	1255%
Multiplan Phcs	$1,340	1255%
Healthsmart Preferred Care	$1,359	1272%
Lewisville Isd/Dls Consulting	$1,435	1344%
Usa Managed Care	$1,531	1433%
Usc Health Services	$1,531	1433%
Galaxy Health Network	$1,627	1523%
UnitedHealthcare	$1,646	1541%
Independent Medical Systems	$1,914	1792%
National Healthcare Solutions	$1,914	1792%

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 $1,914.
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 Medical City Fort Worth 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.