CMS Price Transparency Data

X-ray, lower back

Facility: Gundersen Moundview Hospital and Clinics

Billing Code: 72110 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$130
about 1.2× the $107 Medicare rate · typically $41–$432
modeled estimate · not a bill or quote
What this hospital charges insurers
$515
Well above the fair price
about $385 over the fair price · 4.8× Medicare
Medicare pays $107 Fair price $130 This hospital $515 Cash price $318 Hospital's list price $619

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $37 Priciest $515

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a X-ray, lower back is about $130 (about 1.2× the $107 Medicare rate). Gundersen Moundview Hospital and Clinics charges insurers about $515, or about $318 in cash — well above the fair price. Located in Friendship, WI.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $130. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $384 360%
Blue Cross Blue Shieldmajor $172 - $765 161%
Aetnamajor $588 551%
Humanamajor $526 492%
Amerigroup $24 22%
Dean Health Plan $535 501%
HealthPartners $285 - $547 267%
Quartz $337 316%
Security Health Plan $285 267%
UCare $285 - $495 267%
+ 5 smaller / regional plans $172 - $588
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 402 W Lake St, Friendship, WI 53934
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals