CMS Price Transparency Data

X-ray, lower back

Facility: Children's Hospital of Philadelphia

Billing Code: 72110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72110
Insurance Median: $918
Cash Discount Price: $2,185
vs. Medicare Baseline: 8.59x Medicare

The contracted insurance negotiated median rate for a X-ray, lower back at Children's Hospital of Philadelphia is $918. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,185. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.59x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$2,185

Average discount available for prompt cash payment at this facility.

Insurance Median

$918

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: $2,185 (2046%)

Insurance Median: $918 (859%)

Cash: $2,185 (2046% of Medicare)

Ins. Median: $918 (859% 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 859% of the Medicare baseline (a markup of 759%). 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
Geisinger Medical Assistance	$30	28%
Highmark Wholecare	$34	32%
Horizon Nj Health	$99	93%
Medicaid / KanCare	$361	338%
UnitedHealthcare	$363 - $1,202	340%
Health Partners	$412	386%
Aetna	$575 - $1,093	538%
Upmc Medical Assistance	$597	559%
Keystone First Chip	$677	634%
Keystone Health Plan East	$691	647%
Blue Cross Blue Shield	$771 - $875	722%
Geisinger Health Plan Commercial	$961	900%
Jefferson Health Plans	$1,034	968%
Cigna	$1,093	1023%
Highmark	$1,093	1023%
Qualcare	$1,202	1125%
First Health Network	$1,420	1329%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$1,748	1637%
Private Health Care Systems	$1,748	1637%
Choice Care Network	$1,967	1842%

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 $2,185.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Children's Hospital of Philadelphia is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72110.
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.