CMS Price Transparency Data

X-ray, lower back

Facility: Heritage Valley Sewickley

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $85
Cash Discount Price: $76
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Heritage Valley Sewickley is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.80x the Medicare baseline. Located in 720 Blackburn Road, Sewickley, PA.

Cash / Self-Pay

$76

Average discount available for prompt cash payment at this facility.

Insurance Median

$85

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: $76 (71%)

Insurance Median: $85 (80%)

Cash: $76 (71% of Medicare)

Ins. Median: $85 (80% 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
Aetna	$22 - $205	21%
Blue Cross Blue Shield	$27 - $196	25%
Gateway Health Plan	$27 - $101	25%
UnitedHealthcare	$29 - $126	27%
Upmc Health Plan	$29 - $153	27%
Cigna	$41 - $170	38%
Community Care Behavioral Health	$102	95%

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 $76.
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 Heritage Valley Sewickley 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.