CMS Price Transparency Data

X-ray, ankle

Facility: UPMC Horizon

Billing Code: 73610 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73610
Insurance Median: $352
Cash Discount Price: $541
vs. Medicare Baseline: 3.96x Medicare

The contracted insurance negotiated median rate for a X-ray, ankle at UPMC Horizon is $352. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $541. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.96x the Medicare baseline. Located in 110 North Main Street, Greenville, PA.

Cash / Self-Pay

$541

Average discount available for prompt cash payment at this facility.

Insurance Median

$352

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: $541 (608%)

Insurance Median: $352 (396%)

Cash: $541 (608% of Medicare)

Ins. Median: $352 (396% 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 396% of the Medicare baseline (a markup of 296%). 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
Upmc Health Plan	$26 - $95	29%
Blue Cross Blue Shield	$65 - $450	73%
Upmc Work Partners	$70	79%
Aetna	$86 - $541	97%
UnitedHealthcare	$88 - $360	99%
Amerihealth Caritas	$91	102%
Cigna	$91 - $360	102%
Highmark Wholecare (Prev Gateway)	$91 - $450	102%
Pa Health & Wellness	$91 - $496	102%
Geisinger	$496	558%
Intergroup	$586	659%
Coventry/First Health	$595	669%
Health Coalition Partners	$631	710%
Private Health Care Systems	$721	811%
Prime Net	$739	831%
Humana	$766	862%

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 $541.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 73610.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Horizon is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 73610.
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.