CMS Price Transparency Data

X-ray, pelvis

Facility: UPMC Northwest

Billing Code: 72170 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72170
Insurance Median: $112
Cash Discount Price: $168
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a X-ray, pelvis at UPMC Northwest is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.05x the Medicare baseline. Located in 100 Fairfield Drive, Seneca, PA.

Cash / Self-Pay

$168

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: $168 (157%)

Insurance Median: $112 (105%)

Cash: $168 (157% 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
Upmc Health Plan	$19 - $104	18%
UnitedHealthcare	$20 - $112	19%
Aetna	$21 - $182	20%
Highmark Wholecare (Prev Gateway)	$26 - $140	24%
Amerihealth Caritas	$27 - $109	25%
Pa Health & Wellness	$30 - $109	28%
Upmc Work Partners	$67	63%
Blue Cross Blue Shield	$84 - $104	79%
Cigna	$112 - $182	105%
Intergroup	$182 - $3,704	170%
Coventry/First Health	$196	184%
Health Coalition Partners	$202	189%
Private Health Care Systems	$224	210%
Humana	$238	223%

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 $168.
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 Northwest 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.