CMS Price Transparency Data

X-ray, lower back

Facility: Holy Cross Hospital - Salt Lake

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $463
Cash Discount Price: $392
vs. Medicare Baseline: 4.33x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Holy Cross Hospital - Salt Lake is $463. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $392. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.33x the Medicare baseline. Located in 1050 East South Temple, Salt Lake City, UT.

Cash / Self-Pay

$392

Average discount available for prompt cash payment at this facility.

Insurance Median

$463

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: $392 (367%)

Insurance Median: $463 (433%)

Cash: $392 (367% of Medicare)

Ins. Median: $463 (433% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 433% of the Medicare baseline (a markup of 333%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Denver Health	$30	28%
Health Choice	$30	28%
Medicaid / KanCare	$30	28%
Rocky Mountain Health Plan	$30	28%
Uuhp	$30 - $160	28%
Humana	$35	33%
Medicare (plans)	$35	33%
Employer Direct Healthcare	$44	41%
Motivhealth	$46	43%
Molina	$82 - $421	77%
Centura Employee Plan	$91	85%
Blue Cross Blue Shield	$105 - $588	98%
Cigna	$112 - $784	105%
UnitedHealthcare	$118	110%
Pehp	$418 - $980	391%
Aetna	$433 - $828	405%
Wise	$509 - $519	477%
Deseret Mutual Benefit Administrators	$601	563%
Select Health	$648	607%
Multiplan	$676 - $891	633%
Emi Health	$980	918%

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 $392.
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 Holy Cross Hospital - Salt Lake 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.