CMS Price Transparency Data

X-ray, lower back

Facility: UPMC Mercy

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $434
Cash Discount Price: $766
vs. Medicare Baseline: 4.06x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at UPMC Mercy is $434. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $766. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.06x the Medicare baseline. Located in 1400 Locust Street, Pittsburgh, PA.

Cash / Self-Pay

$766

Average discount available for prompt cash payment at this facility.

Insurance Median

$434

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: $766 (717%)

Insurance Median: $434 (406%)

Cash: $766 (717% of Medicare)

Ins. Median: $434 (406% 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 406% of the Medicare baseline (a markup of 306%). 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
Upmc Health Plan	$40 - $192	37%
UnitedHealthcare	$42	39%
Highmark Wholecare (Prev Gateway)	$54 - $638	51%
Amerihealth Caritas	$58 - $109	54%
Blue Cross Blue Shield	$58 - $332	54%
Pa Health & Wellness	$62 - $109	58%
Aetna	$106 - $510	99%
Upmc Work Partners	$129	121%
Bravo	$319	299%
Cigna	$434 - $766	406%
Coventry/First Health	$561	525%
Intergroup	$638 - $1,021	597%
Private Health Care Systems	$957	896%
American Healthcare Group	$1,021	956%
National Provider Network	$1,046	979%
Health Payors Organization	$1,148	1075%
Multiplan	$1,148	1075%

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 $766.
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 UPMC Mercy 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.