CMS Price Transparency Data

X-ray, lower back

Facility: Hospital of Univ of Pennsylvania

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $310
  • Cash Discount Price: $803
  • vs. Medicare Baseline: 2.90x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Hospital of Univ of Pennsylvania is $310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $803. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.90x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$803

Average discount available for prompt cash payment at this facility.

Insurance Median
$310

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: $803 (752%)
Insurance Median: $310 (290%)
Cash: $803 (752% of Medicare)
Ins. Median: $310 (290% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 290% of the Medicare baseline (a markup of 190%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Medicaid / KanCare $22 - $803 21%
Kaiser Permanente $24 - $803 22%
Keystone Mercy Health Plan $29 - $803 27%
Upmc $34 - $803 32%
Pa Medical Assistance $37 - $803 35%
UnitedHealthcare $44 - $803 41%
Health Partners $45 - $803 42%
Blue Cross Blue Shield $55 - $692 51%
Gspp And Wissahickon Hospice $55 51%
Keystone Hmo Proactive $55 51%
Ibc Commercial Hpn $57 53%
Paired Kidney Exchange $64 60%
Cigna $104 - $361 97%
Medicare (plans) $110 - $112 103%
Philadelphia Va Medical Center $110 103%
Tricare $110 103%
Ibc $112 105%
Geisinger Health Plan $113 - $349 106%
Humana $113 - $642 106%
Devoted Health $115 108%
Pa Health And Wellness $115 - $181 108%
Penn Life (Living Independently For Elders) $115 108%
Aetna $116 - $803 109%
Clover Health Plan $119 111%
Keystone First $122 114%
Us Family Health Plan $126 118%
Gateway Health Plan $136 127%
Horizon Nj Health $136 - $141 127%
Elap $156 146%
Claims Watcher $176 - $198 165%
Preferred Health Care Eliance $177 166%
Pgm - Regie De L'Assurance Maladie Quebec $185 173%
Oscar Health Plan $187 175%
Centivo $198 185%
Elap Services $204 191%
Highmark $231 216%
Pgm - Kuwait Defense $281 - $361 263%
Penn Global Medicine $291 272%
Qualcare $305 286%
Olympus $316 296%
Coventry $321 - $410 301%
Pgm - Chop $321 301%
Wissahickon Hospice $321 301%
Healthamerica/Coventry $361 - $393 338%
First Health Global $402 376%
Health Net $482 451%
Pgm - Royal Embassy Of Saudi Arabia $482 451%
Pgm - Embassy Of Qatar $522 489%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $522 489%
Interlink $538 504%
Pgm - Embassy Of The United Emirates/Ipc $562 526%
Health America/Ccn $642 601%
Intergroup $642 601%
Pgm - Kuwait Health Division $642 601%
Pgm - Kuwait Oil $642 601%
Preferred Care $642 601%
Blue Quality Centers For Transplant (Bqct) $803 752%
City Of Philadelphia Behavioral Health $803 752%
Commercial Other $803 752%
International Pfs $803 752%
United Behavioral Health $803 752%
Workers Compensation $803 752%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals