CMS Price Transparency Data

X-ray, lower back

Facility: UPMC Bedford Memorial

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $186
Cash Discount Price: $190
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at UPMC Bedford Memorial is $186. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.74x the Medicare baseline. Located in 10455 Lincoln Highway, Everett, PA.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$186

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: $190 (178%)

Insurance Median: $186 (174%)

Cash: $190 (178% of Medicare)

Ins. Median: $186 (174% 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
Aetna	$37 - $212	35%
UnitedHealthcare	$38 - $212	36%
Upmc Health Plan	$40 - $192	37%
Geisinger	$51	48%
Highmark Wholecare (Prev Gateway)	$54 - $109	51%
Health Partners Plans (Jefferson Health Plan)	$55	51%
Amerihealth Caritas	$57 - $109	53%
Pa Health & Wellness	$62 - $109	58%
Blue Cross Blue Shield	$101 - $200	95%
Cigna	$109 - $212	102%
Upmc Work Partners	$117	110%
Intergroup	$206 - $285	193%
Coventry/First Health	$222	208%
Preferred Healthcare System	$254	238%
Health Coalition Partners	$285	267%
Humana	$285	267%
Private Health Care Systems	$285	267%
Selectcare	$285	267%

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 $190.
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 Bedford Memorial 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.