CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: UPMC McKeesport Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $268
Cash Discount Price: $424
vs. Medicare Baseline: 3.01x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at UPMC McKeesport Hospital is $268. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $424. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.01x the Medicare baseline. Located in 1500 Fifth Avenue, Mc Keesport, PA.

Cash / Self-Pay

$424

Average discount available for prompt cash payment at this facility.

Insurance Median

$268

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: $424 (477%)

Insurance Median: $268 (301%)

Cash: $424 (477% of Medicare)

Ins. Median: $268 (301% 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 301% of the Medicare baseline (a markup of 201%). 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
UnitedHealthcare	$29	33%
Upmc Health Plan	$29 - $132	33%
Highmark Wholecare (Prev Gateway)	$39 - $91	44%
Blue Cross Blue Shield	$40 - $203	45%
Amerihealth Caritas	$41 - $91	46%
Pa Health & Wellness	$45 - $91	51%
Aetna	$88 - $283	99%
Upmc Work Partners	$90	101%
Cigna	$272 - $424	306%
Intergroup	$354	398%
Coventry/First Health	$495	557%
Private Health Care Systems	$566	637%
Selectcare	$566	637%
Humana	$601	676%

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 $424.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72040.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC McKeesport Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72040.
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.