CMS Price Transparency Data

X-ray, hip

Facility: UPMC Horizon

Billing Code: 73502 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73502
  • Insurance Median: $220
  • Cash Discount Price: $334
  • vs. Medicare Baseline: 2.47x Medicare
The contracted insurance negotiated median rate for a X-ray, hip at UPMC Horizon is $220. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $334. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.47x the Medicare baseline. Located in 110 North Main Street, Greenville, PA.
Cash / Self-Pay
$334

Average discount available for prompt cash payment at this facility.

Insurance Median
$220

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: $334 (376%)
Insurance Median: $220 (247%)
Cash: $334 (376% of Medicare)
Ins. Median: $220 (247% 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 247% of the Medicare baseline (a markup of 147%). 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
Blue Cross Blue Shield $38 - $278 43%
Upmc Work Partners $52 58%
Upmc Health Plan $62 - $222 70%
Aetna $86 - $334 97%
UnitedHealthcare $88 - $223 99%
Amerihealth Caritas $91 102%
Cigna $91 - $223 102%
Highmark Wholecare (Prev Gateway) $91 - $278 102%
Pa Health & Wellness $91 - $306 102%
Geisinger $306 344%
Intergroup $362 407%
Coventry/First Health $368 414%
Health Coalition Partners $390 439%
Private Health Care Systems $446 502%
Prime Net $457 514%
Humana $473 532%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 110 North Main Street, Greenville, PA 16125
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals