CMS Price Transparency Data

X-ray, lower back

Facility: UPMC Pinnacle Hospitals

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $112
Cash Discount Price: $210
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at UPMC Pinnacle Hospitals is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $210. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.05x the Medicare baseline. Located in 409 South Second Street, Harrisburg, PA.

Cash / Self-Pay

$210

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $210 (197%)

Insurance Median: $112 (105%)

Cash: $210 (197% of Medicare)

Ins. Median: $112 (105% 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
Blue Cross Blue Shield	$15 - $257	14%
Keystone Health Plan	$15 - $182	14%
Prime Net	$19 - $329	18%
UnitedHealthcare	$29 - $112	27%
Aetna	$45 - $322	42%
Amerihealth Caritas	$47	44%
Health Partners Plans (Jefferson Health Plan)	$50	47%
Intergroup	$50 - $372	47%
Geisinger	$53	50%
Pa Health & Wellness	$62 - $113	58%
Wellspan Population Health	$65 - $372	61%
Humana	$108	101%
Cigna	$110	103%
Premier Comp Solutions	$123	115%
Upmc Work Partners	$126	118%
Upmc Health Plan	$192	180%

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 $210.
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 Pinnacle Hospitals 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.