CMS Price Transparency Data

X-ray, lower back

Facility: UPMC Northwest

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $172
Cash Discount Price: $257
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at UPMC Northwest is $172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $257. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.61x the Medicare baseline. Located in 100 Fairfield Drive, Seneca, PA.

Cash / Self-Pay

$257

Average discount available for prompt cash payment at this facility.

Insurance Median

$172

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: $257 (241%)

Insurance Median: $172 (161%)

Cash: $257 (241% of Medicare)

Ins. Median: $172 (161% 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	$40 - $104	37%
UnitedHealthcare	$42 - $112	39%
Aetna	$44 - $279	41%
Highmark Wholecare (Prev Gateway)	$54 - $214	51%
Amerihealth Caritas	$57 - $109	53%
Pa Health & Wellness	$62 - $109	58%
Blue Cross Blue Shield	$101 - $187	95%
Upmc Work Partners	$120	112%
Cigna	$172 - $279	161%
Intergroup	$279 - $3,704	261%
Coventry/First Health	$300	281%
Health Coalition Partners	$309	289%
Private Health Care Systems	$343	321%
Humana	$365	342%

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 $257.
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 Northwest 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.