CMS Price Transparency Data

X-ray, lower back

Facility: Gundersen St Josephs Hospital and Clinics

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $758
  • Cash Discount Price: $625
  • vs. Medicare Baseline: 7.10x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Gundersen St Josephs Hospital and Clinics is $758. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $625. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.10x the Medicare baseline. Located in 400 Water Ave, Hillsboro, WI.
Cash / Self-Pay
$625

Average discount available for prompt cash payment at this facility.

Insurance Median
$758

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: $625 (585%)
Insurance Median: $758 (710%)
Cash: $625 (585% of Medicare)
Ins. Median: $758 (710% 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 710% of the Medicare baseline (a markup of 610%). 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
Amerigroup $24 22%
Blue Cross Blue Shield $147 - $765 138%
Iowa Total Care $147 138%
Managed Health Service $147 138%
Security Health Plan $211 198%
Ucare $559 - $860 523%
UnitedHealthcare $570 - $751 534%
Quartz $586 549%
Alliance $859 - $1,850 804%
Cigna $882 826%
Aspirus Arise Health $892 835%
Humana $914 856%
Multiplan/Healtheos $935 - $1,021 875%
Coventry Health Care $1,021 956%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 Water Ave, Hillsboro, WI 54634
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals