CMS Price Transparency Data

X-ray, lower back

Facility: Memorial Hospital of Carbon County

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $204
Cash Discount Price: $249
vs. Medicare Baseline: 1.91x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Memorial Hospital of Carbon County is $204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $249. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.91x the Medicare baseline. Located in 2221 West Elm Street, Rawlins, WY.

Cash / Self-Pay

$249

Average discount available for prompt cash payment at this facility.

Insurance Median

$204

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: $249 (233%)

Insurance Median: $204 (191%)

Cash: $249 (233% of Medicare)

Ins. Median: $204 (191% 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
Lhi	$103	96%
Three_River_Providers_Network	$104 - $394	97%
Wise_Provider_Networks	$104 - $394	97%
Zelis	$104 - $394	97%
Corechoice	$125 - $473	117%
First_Choice_Health	$125 - $473	117%
Blue Cross Blue Shield	$128 - $484	120%
Cigna	$129 - $489	121%
UnitedHealthcare	$133 - $505	125%
Interwests_Ppo_Network	$135 - $510	126%
Multiplan	$135 - $510	126%
Medicare (plans)	$274	257%
Vaccn	$274	257%
Medicaid / KanCare	$526	492%

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 $249.
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 Memorial Hospital of Carbon County 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.