CMS Price Transparency Data

X-ray, lower back

Facility: Aurora Medical Center

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $339
  • Cash Discount Price: $515
  • vs. Medicare Baseline: 3.17x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Aurora Medical Center is $339. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $515. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.17x the Medicare baseline. Located in 975 Port Washington Road, Grafton, WI.
Cash / Self-Pay
$515

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: $515 (482%)
Insurance Median: $339 (317%)
Cash: $515 (482% 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 - $851 187%
Aurora Caregiver $240 225%
Quartz One $245 229%
Common Ground $249 233%
Everpointe Elite $259 242%
Healthpartners $266 - $772 249%
Blue Cross Blue Shield $275 - $876 257%
Quartz Group $290 272%
Hs Technology $293 274%
Wisconsin Physician Service $299 - $315 280%
Molina Exchange $308 288%
Centivo $328 307%
UnitedHealthcare $336 - $867 315%
Health Payment Systems $400 374%
Trilogy $410 384%
Cigna $460 - $871 431%
Health Eos Plus $618 579%
Health Eos $824 771%

Consumer Guidance & Cost Commentary

For patients paying cash directly, the most important takeaway is that the facility's cash median rate of $515 is significantly lower than the typical negotiated rates charged to insurance members, which range from $200 to $876 depending on the plan. While some insurance plans, such as Aurora Caregiver and Quartz One, have a fixed rate of $240 that is lower than the cash price, many other payers like UnitedHealthcare and Cigna charge rates as high as $876, making the upfront cash payment of $515 a potentially more economical option for those with high-deductible plans or no coverage. Patients should proactively ask the hospital staff about "self-pay" or "prompt-pay" discounts at the time of scheduling, as these upfront fees can further reduce the cost compared to the standard cash rate.

The broader pricing context reveals that while the cash rate of $515 is competitive, the facility's gross charge of $1,030 represents the maximum billed amount before any discounts are applied. It is worth noting that the facility's cash rate is higher than the Medicare benchmark of $106.81, which serves as a federal cost baseline, yet the negotiated rates vary widely across the 18 different payers listed. For instance, while UnitedHealthcare's range spans from $336 to $867, some plans like Common Ground and Health Eos Plus have a consistent rate of $290 and $618 respectively, all of which exceed the cash price for many. Consumers are encouraged to request an itemized bill to verify that no balance billing occurs for out-of-network ancillary services and to ensure they are

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 Port Washington Road, Grafton, WI 53024
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals