CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: St Luke's Hospital - Upper Bucks Campus

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $93
Cash Discount Price: $792
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at St Luke's Hospital - Upper Bucks Campus is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $792. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.05x the Medicare baseline. Located in 3000 St. Luke's Drive, Quakertown, PA.

Cash / Self-Pay

$792

Average discount available for prompt cash payment at this facility.

Insurance Median

$93

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: $792 (891%)

Insurance Median: $93 (105%)

Cash: $792 (891% of Medicare)

Ins. Median: $93 (105% 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.

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
Keystone First	$26	29%
Geisinger	$31 - $247	35%
Amerihealth Caritas	$32	36%
Highmark Wholecare	$32	36%
Upmc Health Plan	$32 - $241	36%
Jefferson Health Plan	$38	43%
Blue Cross Blue Shield	$88 - $729	99%
Highmark	$90 - $312	101%
Aetna	$92 - $307	103%
Humana	$94	106%
UnitedHealthcare	$97 - $254	109%
Oscar	$228	256%
Cigna	$241	271%

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 $792.
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 St Luke's Hospital - Upper Bucks Campus 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.