CMS Price Transparency Data

X-ray, lower back

Facility: Primary Children's Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $219
  • Cash Discount Price: $232
  • vs. Medicare Baseline: 2.05x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Primary Children's Hospital is $219. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $232. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.05x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$232

Average discount available for prompt cash payment at this facility.

Insurance Median
$219

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: $232 (217%)
Insurance Median: $219 (205%)
Cash: $232 (217% of Medicare)
Ins. Median: $219 (205% 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 205% of the Medicare baseline (a markup of 105%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
American Health $12 - $176 11%
Health Plan Of Nevada $12 - $52 11%
Healthy U $12 - $61 11%
Molina $12 - $260 11%
Selecthealth $12 - $260 11%
Southwest Behavioral Health $12 - $100 11%
UnitedHealthcare $12 - $260 11%
Tricare $102 95%
Triwest $102 95%
Donor Connect $111 - $123 104%
Aetna $219 - $263 205%
Awh Connected $219 - $263 205%
Byu Athletics $219 - $260 205%
Campbell Scientific $219 - $260 205%
Cigna $219 - $260 205%
Deseret Mutual $219 - $260 205%
Emi $219 - $260 205%
Emi Health $219 - $260 205%
First Choice $219 - $260 205%
First Choice Of The Midwest $219 - $260 205%
Franklin County $219 - $260 205%
Global Excel $219 - $260 205%
Health Utah $219 - $260 205%
Humana $219 - $260 205%
Hygeia Corporation $219 - $260 205%
Ifit $219 - $260 205%
Juniper Systems $219 - $260 205%
Lw Miller $219 - $260 205%
Managed Care Admin $219 - $260 205%
Medcare International $219 - $260 205%
Motivhealth $219 - $260 205%
Pehp $219 - $260 205%
Prodegi Corp Benefit $219 - $260 205%
Tanner Llc $219 - $260 205%
Uofu $219 - $260 205%
Utah Tech $219 - $260 205%
Wise Network $219 - $260 205%
First Health $222 - $263 208%
Blue Cross Blue Shield $226 - $266 212%
Springtide $226 - $266 212%
Utah Behavioral Health Network $250 234%
Altius Mhnet Behavioral Health $272 255%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens