CMS Price Transparency Data

X-ray, lower back

Facility: Bertrand Chaffee Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $39
Cash Discount Price: $82
vs. Medicare Baseline: 0.37x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Bertrand Chaffee Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.37x the Medicare baseline. Located in 224 East Main Street, Springville, NY.

Cash / Self-Pay

$82

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $82 (77%)

Insurance Median: $39 (37%)

Cash: $82 (77% of Medicare)

Ins. Median: $39 (37% 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
Private Pay	$17 - $146	16%
Community Care - Bc	$18	17%
Univera Hc Myhealth+	$18 - $42	17%
Ghi Medical	$18	17%
Univera Hc Myhealth	$18	17%
Medicaid / KanCare	$18	17%
Fidelis Care of New York	$18	17%
Seneca Nation Health Dept	$18	17%
Gowanda Correctional Fac	$18	17%
United Hc - Community Pln	$18	17%
Molina Essential Plan	$18	17%
Comm Blue Essential	$18	17%
Molina Heathcare of Wny	$18	17%
United Hc Essential Plan	$18	17%
Community Blue	$18	17%
Yourcare	$18	17%
Aetna	$20 - $172	19%
No Amer Meritian Health	$20 - $172	19%
Guardian Life Ins. Co.	$20 - $172	19%
Mvp Commercial	$20 - $172	19%
Global Excel Mgt	$20 - $172	19%
Cigna	$20 - $172	19%
No-Fault	$20 - $172	19%
American Progressive Ins.	$20 - $172	19%
Commercial / Misc	$20 - $172	19%
Blue Cross Blue Shield	$37 - $39	35%
Senior Blue - Bc	$37	35%
Fidelis Essential Plans	$41	38%
Univera Plus Med	$42	39%
Univera Hc Child Health+	$42	39%
Univera Essential Plans	$42	39%
Univera Senior Choice	$50	47%
Univera Healthcare	$60	56%
Iha Essential Plans	$82 - $91	77%
Iha Medisource	$82 - $91	77%
Iha Encompass 65	$127 - $131	119%
Iha	$131	123%
Iha Custom Coverage	$131	123%

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 $82.
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 Bertrand Chaffee 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.