CMS Price Transparency Data

X-ray, lower back

Facility: Pennsylvania Hospital

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72110
  • Insurance Median: $569
  • Cash Discount Price: $1,497
  • vs. Medicare Baseline: 5.33x Medicare
The contracted insurance negotiated median rate for a X-ray, lower back at Pennsylvania Hospital is $569. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,497. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.33x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$1,497

Average discount available for prompt cash payment at this facility.

Insurance Median
$569

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: $1,497 (1402%)
Insurance Median: $569 (533%)
Cash: $1,497 (1402% of Medicare)
Ins. Median: $569 (533% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 533% of the Medicare baseline (a markup of 433%). 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
Gateway Health Plan $22 - $136 21%
Medicaid / KanCare $22 - $1,497 21%
Keystone Mercy Health Plan $29 27%
Upmc $34 - $1,497 32%
Pa Medical Assistance $37 35%
UnitedHealthcare $44 - $1,497 41%
Health Partners $45 - $1,497 42%
Blue Cross Blue Shield $55 - $1,497 51%
Keystone Hmo Proactive $55 51%
Ibc Commercial Hpn $57 53%
Cigna $104 - $113 97%
Medicare (plans) $109 - $112 102%
Philadelphia Va Medical Center $109 102%
Tricare $110 103%
Ibc $112 105%
Geisinger Health Plan $113 - $347 106%
Humana $113 - $1,198 106%
Pa Health And Wellness $115 - $180 108%
Penn Life (Living Independently For Elders) $115 108%
Aetna $116 - $1,497 109%
Clover Health Plan $118 110%
Keystone First $121 113%
Us Family Health Plan $126 118%
Elap $155 145%
Claims Watcher $175 - $197 164%
Oscar Health Plan $186 174%
Centivo $197 184%
Elap Services $203 190%
Highmark $230 215%
Horizon Nj Health $253 - $263 237%
Penn Global Medicine $290 272%
Pgm - Regie De L'Assurance Maladie Quebec $344 322%
Preferred Health Care Eliance $389 364%
Pgm - Kuwait Defense $524 - $674 491%
Devon $569 - $674 533%
Qualcare $569 533%
Coventry $599 - $763 561%
Pgm - Chop $599 561%
Wissahickon Hospice $599 561%
Healthamerica/Coventry $674 - $734 631%
Olympus $728 682%
First Health Global $748 700%
Urn-Cancer Resource Services $748 700%
Health Net $898 841%
Pgm - Royal Embassy Of Saudi Arabia $898 841%
Pgm - Embassy Of Qatar $973 911%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $973 911%
Pgm - Embassy Of The United Emirates/Ipc $1,048 981%
Devon Health Services Inc $1,198 1122%
Health America/Ccn $1,198 1122%
Intergroup $1,198 1122%
Pgm - Kuwait Health Division $1,198 1122%
Pgm - Kuwait Oil $1,198 1122%
Preferred Care $1,198 1122%
Commercial Other $1,497 1402%
Community Behavioral Health $1,497 1402%
International Pfs $1,497 1402%
Quest Behavioral Health $1,497 1402%
United Behavioral Health $1,497 1402%
Workers Compensation $1,497 1402%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals