CMS Price Transparency Data

X-ray, lower back

Facility: Aurora Medical Center Sheboygan County

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $339
  • Cash Discount Price: $420
  • vs. Medicare Baseline: 3.17x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Aurora Medical Center Sheboygan County is $339. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $420. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.17x the Medicare baseline. Located in 2629 N 7Th St, Sheboygan, WI.
Cash / Self-Pay
$420

Average discount available for prompt cash payment at this facility.

Insurance Median
$339

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: $420 (393%)
Insurance Median: $339 (317%)
Cash: $420 (393% of Medicare)
Ins. Median: $339 (317% 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 317% of the Medicare baseline (a markup of 217%). 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
Aetna $200 - $694 187%
Aurora Caregiver $240 225%
Quartz One $245 229%
Common Ground $249 233%
Everpointe Elite $259 242%
Healthpartners $266 - $630 249%
Blue Cross Blue Shield $275 - $714 257%
Quartz Group $290 272%
Hs Technology $293 274%
Wisconsin Physician Service $299 - $315 280%
Molina Exchange $308 288%
Centivo $328 307%
UnitedHealthcare $336 - $707 315%
Health Payment Systems $400 374%
Trilogy $410 384%
Cigna $460 - $711 431%
Health Eos Plus $504 472%
Health Eos $672 629%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2629 N 7Th St, Sheboygan, WI 53083
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals