CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Geisinger-Lewistown Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $356
Cash Discount Price: $510
vs. Medicare Baseline: 4.00x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Geisinger-Lewistown Hospital is $356. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $510. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.00x the Medicare baseline. Located in 400 Highland Avenue, Lewistown, PA.

Cash / Self-Pay

$510

Average discount available for prompt cash payment at this facility.

Insurance Median

$356

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: $510 (574%)

Insurance Median: $356 (400%)

Cash: $510 (574% of Medicare)

Ins. Median: $356 (400% 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 400% of the Medicare baseline (a markup of 300%). 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
Medicaid / KanCare	$26	29%
Geisinger Family Plan	$28	31%
Amerihealth	$29	33%
Upmc Health Plan	$31 - $11,890	35%
Health Partners	$32	36%
Upmc Chip	$33	37%
Blue Cross Blue Shield	$85 - $445	96%
Geisinger Health Plan	$85 - $400	96%
Medicare (plans)	$85	96%
Advantra	$86	97%
Humana	$86	97%
Ambetter / Centene	$205	231%
Aetna	$336 - $399	378%
Cigna	$356 - $432	400%
UnitedHealthcare	$364	409%
Christian Healthcare Ministries	$411	462%
Christian Health Aid	$658	740%
Three Rivers Provider Network Inc.	$658	740%
Multiplan	$699	786%
Healthsmart Payors Organization	$740	832%

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 $510.
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 Geisinger-Lewistown 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.