CMS Price Transparency Data

X-ray, foot

Facility: UPMC Presbyterian Shadyside

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $744
Cash Discount Price: $686
vs. Medicare Baseline: 8.37x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at UPMC Presbyterian Shadyside is $744. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $686. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 8.37x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

$686

Average discount available for prompt cash payment at this facility.

Insurance Median

$744

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)

Cash / Self-Pay: $686 (772%)

Insurance Median: $744 (837%)

Cash: $686 (772% of Medicare)

Ins. Median: $744 (837% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $88.91 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 837% of the Medicare baseline (a markup of 737%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$14 - $91	16%
Blue Cross Blue Shield	$34 - $223	38%
Upmc Work Partners	$74	83%
Multiplan	$86 - $915	97%
Amerihealth Caritas	$91	102%
Cigna	$91	102%
Highmark Wholecare (Prev Gateway)	$91 - $572	102%
Pa Health & Wellness	$91	102%
Aetna	$92 - $286	103%
Upmc Health Plan	$536	603%
Geisinger	$629	707%
Preferred Healthcare System	$744	837%
Coventry/First Health	$801	901%
Fidelis	$858	965%
Intergroup	$858 - $972	965%
Health Coalition Partners	$915	1029%
Private Health Care Systems	$915	1029%
Selectcare	$915	1029%
Health Payors Organization	$972	1093%
Humana	$972	1093%

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 $686.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73630.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Presbyterian Shadyside is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73630.
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.