CMS Price Transparency Data

X-ray, pelvis

Facility: UPMC Hamot

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $151
Cash Discount Price: $335
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at UPMC Hamot is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $335. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.41x the Medicare baseline. Located in 201 State Street, Erie, PA.

Cash / Self-Pay

$335

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $335 (314%)

Insurance Median: $151 (141%)

Cash: $335 (314% of Medicare)

Ins. Median: $151 (141% 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
Upmc Health Plan	$19 - $119	18%
Blue Cross Blue Shield	$20 - $157	19%
UnitedHealthcare	$20 - $254	19%
Aetna	$21 - $391	20%
Geisinger	$24	22%
Health Partners Plans (Jefferson Health Plan)	$26	24%
Highmark Wholecare (Prev Gateway)	$26 - $279	24%
Amerihealth Caritas	$27 - $126	25%
Pa Health & Wellness	$30 - $126	28%
Upmc Work Partners	$72	67%
Univera	$84 - $246	79%
Fidelis	$117	110%
Wellcare	$121	113%
Cigna	$126 - $223	118%
Independent Health	$166 - $222	155%
Intergroup	$363 - $446	340%
Multiplan	$391 - $446	366%

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 $335.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72170.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Hamot is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72170.
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.