CMS Price Transparency Data

X-ray, lower back

Facility: Methodist Southlake Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $170
  • Cash Discount Price: $531
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Methodist Southlake Medical Center is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $531. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.59x the Medicare baseline. Located in 421 E State Highway 114, Southlake, TX.
Cash / Self-Pay
$531

Average discount available for prompt cash payment at this facility.

Insurance Median
$170

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: $531 (497%)
Insurance Median: $170 (159%)
Cash: $531 (497% of Medicare)
Ins. Median: $170 (159% 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
UnitedHealthcare $50 - $453 47%
Champva [1000] $102 95%
Tricare $102 95%
Triwest Wps [8010] $102 95%
Veterans Administration [9001] $102 95%
Aetna $105 - $595 98%
Blue Cross Blue Shield $105 - $360 98%
Medicare (plans) $105 - $113 98%
Ust Health Proof [1005] $105 98%
Wellcare [7016] $105 98%
American Health Advantage Of Texas [7099] $110 103%
Cigna $110 - $195 103%
Globalhealth [1003] $110 103%
Procare Advantage [7018] $110 103%
Humana $112 105%
Southwestern Health Resources Swhr [7015] $112 105%
Provider Partners Health Plan [7025] $114 107%
Alternative Service Concepts [8005] $131 123%
Oscar Insurance Company [2057] $137 128%
Bright Healthcare [2222] $147 138%
Molina [3017] $153 143%
Wellpoint Marketplace Exchange [3071] $163 153%
Web Tpa [3049] $165 - $195 154%
Kempton Group Administrators, Tower Extrusions [3061] $168 157%
90 Degree Benefit [3057] $174 163%
Allied National [2031] $174 163%
Entrust/90 Degree [2058] $174 163%
Friday Health Plan [2061] $179 168%
Ambetter / Centene $180 169%
Medicaid / KanCare $184 - $223 172%
Imperial Insurance Companies [3073] $189 177%
Department Of Labor [8004] $210 197%
Evry Health [1013] $210 197%
Generic Workers Comp Tx Non Par [9010] $210 197%
Generic Workers Comp Tx Par [8002] $210 197%
Generic Workers Comp Tx Par [9011] $210 197%
Sana Benefits [3069] $210 197%
Tristar Risk Management [8006] $210 197%
Velocity [3070] $210 197%
Health Plans Inc [5017] $263 246%
Medical Cost Containment Professionals [3059] $263 246%
Dart Member Care [3039] $284 266%
Healthscope Benefits [2052] $284 266%
Healthscope Benefits [3063] $284 266%
Bind Benefits Inc [1004] $453 424%
Definity Health [3006] $453 424%
Freedom Life Insurance Company [2029] $453 424%
Geha Federal [3066] $453 424%
Tml Intergovernmental Employee Benefits [3050] $453 424%
Scott & White Health Plan Trs [3062] $595 557%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 421 E State Highway 114, Southlake, TX 76092
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals