CMS Price Transparency Data

X-ray, lower back

Facility: St Joseph's Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $736
Cash Discount Price: $827
vs. Medicare Baseline: 6.89x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at St Joseph's Hospital is $736. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $827. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.89x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.

Cash / Self-Pay

$827

Average discount available for prompt cash payment at this facility.

Insurance Median

$736

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: $827 (774%)

Insurance Median: $736 (689%)

Cash: $827 (774% of Medicare)

Ins. Median: $736 (689% 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 689% of the Medicare baseline (a markup of 589%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Cigna	$104	97%
Molina Healthcare	$113 - $230	106%
Meridian Health Plan	$119	111%
Sae Hospice	$230	215%
Clear Spring Health of Illinois	$230	215%
Humana	$230	215%
UnitedHealthcare	$230 - $1,149	215%
Blue Cross Blue Shield	$230	215%
Aetna	$230 - $803	215%
Amish Community	$322	301%
Naphcare	$483	452%
Celtic Insurance Company	$506	474%
Hopetrust	$574	537%
Claim Doc	$574	537%
Caterpillar, Inc.	$708	663%
Wellfirst	$736	689%
First Health	$849	795%
Healthlink	$977	915%
Multiplan/Phcs	$977	915%
Healthcare Finest Network (Hfn)	$1,034	968%
Provider Network of America	$1,034	968%
Interplan	$1,149	1076%
Current Health Solutions	$1,149	1076%
Mental Health Network	$1,149	1076%
Healthscope	$1,149	1076%
Qtc Medical Group of Illinois	$1,149	1076%
Illinois Breast and Cervical Cancer Program	$1,149	1076%
Consociate Group	$1,149	1076%
Health Alliance Medical Plans	$1,149	1076%

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 $827.
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 St Joseph's Hospital 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.