CMS Price Transparency Data

X-ray, lower back

Facility: Community Memorial Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $554
  • Cash Discount Price: $438
  • vs. Medicare Baseline: 5.19x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Community Memorial Hospital is $554. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $438. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.19x the Medicare baseline. Located in W180 N8085 Town Hall Rd, Menomonee Falls, WI.
Cash / Self-Pay
$438

Average discount available for prompt cash payment at this facility.

Insurance Median
$554

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: $438 (410%)
Insurance Median: $554 (519%)
Cash: $438 (410% of Medicare)
Ins. Median: $554 (519% 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 519% of the Medicare baseline (a markup of 419%). 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
Blue Cross Blue Shield $66 - $677 62%
Allwell $103 96%
Community Care $103 96%
Health Partners $103 - $517 96%
Humana $103 96%
Icare $103 96%
Network Health Plan $103 - $399 96%
Security Health Plan $103 96%
UnitedHealthcare $103 - $597 96%
Aetna $105 - $557 98%
Care Wisconsin/Mychoice $106 99%
Centivo $239 - $263 224%
Sheboygan Employers Health Network $293 274%
Froedtert South $334 313%
Chorus Community Health Plan $342 320%
Common Ground $478 448%
Trilogy $549 514%
Health Payment Systems $554 519%
Wisconsin Physician Services $557 521%
Aspirus $637 596%
Ibsi Passport $645 604%
Americas Choice $693 649%
Federated Mutual $693 649%
Healtheos $693 649%
Multiplan/Private Healthcare Systems $693 649%
Savility $693 649%
Cigna $700 655%
First Health Network $700 655%
Healthsmart $716 670%
Physicians Plus $716 670%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: W180 N8085 Town Hall Rd, Menomonee Falls, WI 53051
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals