CMS Price Transparency Data

X-ray, lower back

Facility: Stephens Memorial Hospital

Billing Code: 72110 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$168
about 1.6× the $107 Medicare rate · typically $43–$373
modeled estimate · not a bill or quote
Medicare pays $107 Fair price $168 Cash price $171 Hospital's list price $244

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $86 - $592 81%
Blue Cross Blue Shieldmajor $190 - $633 178%
Aetnamajor $135 - $633 126%
Cignamajor $169 - $177 158%
Humanamajor $90 - $285 84%
+ 1 smaller / regional plan $460
Government programs also on file: Medicaid.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 200 South Geneva Street, Breckenridge, TX 76424
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals