CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Gettysburg Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $155
Cash Discount Price: $155
vs. Medicare Baseline: 1.74x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Gettysburg Hospital is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $155. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.74x the Medicare baseline. Located in 147 Gettys Street, Gettysburg, PA.

Cash / Self-Pay

$155

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $155 (174%)

Insurance Median: $155 (174%)

Cash: $155 (174% of Medicare)

Ins. Median: $155 (174% 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
Medicaid / KanCare	$21 - $158	24%
Aetna	$90 - $178	101%
Johns_Hopkins_Healthcare_Plan	$90 - $180	101%
Medicare (plans)	$90 - $109	101%
Blue_Cross	$93 - $168	105%
Wellspan_Capital_Blue_Cross	$108	121%
Upmc_For_Life_Community_Healthchoices	$109	123%
Highmark	$135 - $527	152%
Phc	$155	174%
Upmc	$155 - $180	174%
Cigna	$174 - $180	196%
First_Health_Network	$177 - $178	199%
Geisinger	$184	207%
United_Healthcare	$498	560%

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 $155.
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 Gettysburg 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.