CMS Price Transparency Data

X-ray, foot

Facility: UPMC Horizon

Billing Code: 73630 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 73630
Insurance Median: $305
Cash Discount Price: $469
vs. Medicare Baseline: 3.43x Medicare

The contracted insurance negotiated median rate for a X-ray, foot at UPMC Horizon is $305. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $469. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.43x the Medicare baseline. Located in 110 North Main Street, Greenville, PA.

Cash / Self-Pay

$469

Average discount available for prompt cash payment at this facility.

Insurance Median

$305

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: $469 (527%)

Insurance Median: $305 (343%)

Cash: $469 (527% of Medicare)

Ins. Median: $305 (343% 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 343% of the Medicare baseline (a markup of 243%). 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	$31 - $113	35%
Blue Cross Blue Shield	$65 - $390	73%
Upmc Work Partners	$70	79%
Aetna	$86 - $469	97%
UnitedHealthcare	$88 - $312	99%
Amerihealth Caritas	$91	102%
Cigna	$91 - $312	102%
Highmark Wholecare (Prev Gateway)	$91 - $390	102%
Pa Health & Wellness	$91 - $430	102%
Geisinger	$430	484%
Intergroup	$508	571%
Coventry/First Health	$515	579%
Health Coalition Partners	$547	615%
Private Health Care Systems	$625	703%
Prime Net	$640	720%
Humana	$664	747%

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 $469.
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 Horizon 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.