CMS Price Transparency Data

X-ray, lower back

Facility: Ascension Seton Highland Lakes

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $137
Cash Discount Price: $215
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Ascension Seton Highland Lakes is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $215. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.28x the Medicare baseline. Located in Highway 281 South, Burnet, TX.

Cash / Self-Pay

$215

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $215 (201%)

Insurance Median: $137 (128%)

Cash: $215 (201% of Medicare)

Ins. Median: $137 (128% 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
Champva	$34 - $47	32%
Ambetter / Centene	$46 - $51	43%
Blue Cross Blue Shield	$46 - $454	43%
Dell Chip/Chip Perinate	$46 - $137	43%
Dell Star	$46 - $137	43%
UnitedHealthcare	$46 - $137	43%
Wellpoint Chip/Chip Perinate	$46 - $135	43%
Wellpoint Star	$46 - $137	43%
Wellpoint Star Plus	$46 - $137	43%
Superior Star	$51 - $276	48%
Superior Star Plus	$51 - $276	48%
Wellpoint Star Kids	$51 - $135	48%
Humana	$67	63%
Tricare	$97	91%
Aetna	$201 - $368	188%
Superior Star Foster	$202 - $276	189%
Superior Star Kids	$202 - $276	189%
Superior Chip/Chip Perinate	$227 - $310	213%
Seton Performance Plus	$251	235%
Cigna	$350	328%
Covenant Health	$368	345%

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 $215.
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 Ascension Seton Highland Lakes 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.