CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: UPMC Carlisle

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $129
  • Cash Discount Price: $188
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at UPMC Carlisle is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $188. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.45x the Medicare baseline. Located in 361 Alexander Spring Road, Carlisle, PA.
Cash / Self-Pay
$188

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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: $188 (211%)
Insurance Median: $129 (145%)
Cash: $188 (211% of Medicare)
Ins. Median: $129 (145% 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.

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 $22 - $231 25%
Amerihealth Caritas $34 38%
Highmark Wholecare (Prev Gateway) $34 38%
Upmc Health Plan $34 - $220 38%
Health Partners Plans (Jefferson Health Plan) $36 40%
Geisinger $39 - $227 44%
Prime Net $43 - $237 48%
Pa Health & Wellness $45 - $91 51%
Blue Cross Blue Shield $63 - $263 71%
Keystone Health Plan $63 - $172 71%
Premier Comp Solutions $83 93%
Upmc Work Partners $83 93%
Humana $84 94%
Aetna $88 - $154 99%
Cigna $88 - $419 99%
Keystone Autism Services $135 152%
Wellspan Population Health $204 - $251 229%
Multiplan $267 300%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 361 Alexander Spring Road, Carlisle, PA 17015
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals