CMS Price Transparency Data

X-ray, chest (two views)

Facility: UPMC Somerset

Billing Code: 71046 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 71046
Insurance Median: $96
Cash Discount Price: $153
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a X-ray, chest (two views) at UPMC Somerset is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $153. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.08x the Medicare baseline. Located in 225 South Center Avenue, Somerset, PA.

Cash / Self-Pay

$153

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $153 (172%)

Insurance Median: $96 (108%)

Cash: $153 (172% of Medicare)

Ins. Median: $96 (108% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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
Blue Cross Blue Shield	$12 - $158	13%
Geisinger	$15 - $124	17%
Aetna	$16 - $126	18%
UnitedHealthcare	$17 - $135	19%
Multiplan	$20 - $204	22%
Galaxy Health Plan	$25 - $204	28%
Upmc Health Plan	$26 - $135	29%
Amerihealth Caritas	$27 - $84	30%
Humana	$29 - $236	33%
Highmark Wholecare (Prev Gateway)	$30 - $91	34%
Upmc Work Partners	$38	43%

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 $153.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 71046.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Somerset is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 71046.
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.