CMS Price Transparency Data

X-ray, lower back

Facility: Unitypoint Health - Meriter

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $103
Cash Discount Price: $606
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Unitypoint Health - Meriter is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $606. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.96x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

$606

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

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: $606 (567%)

Insurance Median: $103 (96%)

Cash: $606 (567% of Medicare)

Ins. Median: $103 (96% 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.

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
Aspirus	$12 - $694	11%
Blue Cross Blue Shield	$12 - $1,099	11%
Illinicare	$12 - $103	11%
Prevea 360	$12 - $984	11%
UnitedHealthcare	$12 - $478	11%
Humana	$13 - $103	12%
Meridiancare	$13 - $103	12%
Wellmark Uph Self-Funded	$28 - $668	26%
Health Partners Open Network	$31 - $422	29%
Medical Associates Health Plan	$39 - $417	37%
Cigna	$79 - $347	74%
Security Health Plan	$85 - $359	80%
Mercy Care	$99 - $384	93%
Quartz	$361	338%

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 $606.
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 Unitypoint Health - Meriter 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.