CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Lancaster General Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $244
  • Cash Discount Price: $309
  • vs. Medicare Baseline: 2.74x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Lancaster General Hospital is $244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $309. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.74x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$309

Average discount available for prompt cash payment at this facility.

Insurance Median
$244

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: $309 (348%)
Insurance Median: $244 (274%)
Cash: $309 (348% of Medicare)
Ins. Median: $244 (274% 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 274% of the Medicare baseline (a markup of 174%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicaid / KanCare $16 - $172 18%
UnitedHealthcare $18 - $309 20%
Gateway $19 21%
Upmc For You $40 45%
Blue Cross Blue Shield $47 - $309 53%
Hospice And Community Care $53 - $69 60%
Cigna $69 - $275 78%
Old Order Group $75 - $116 84%
Lg Coresource/Lg Eliance $79 - $104 89%
Tricare $80 90%
Lancashire Hall $83 - $364 93%
Nursing Home Op Services $83 - $109 93%
Albright Life $88 99%
Coatesville Va $88 99%
Highmark $88 - $364 99%
Hospice Generic $88 99%
Lebanon Veterans Hospital $88 99%
Medicare (plans) $88 - $98 99%
Aetna $89 - $246 100%
Amerihealth Caritas $90 101%
Health Partners Mcr Advantage $91 102%
Devoted Health $93 105%
Pa Health And Wellness Mcr $93 105%
Affilia Home Health $111 - $364 125%
Masonic Homes $116 - $364 130%
Elap Employees $126 142%
Oscar Health Plan $172 193%
Eliance Health Solutions $177 - $233 199%
Highmark Commercial Preferred $185 - $364 208%
Ehp $227 - $298 255%
Upmc Commercial $227 - $309 255%
Devon $235 - $309 264%
Geisinger Commercial $235 - $309 264%
Intergroup Services $235 - $309 264%
Preferred Healthcare $235 - $309 264%
Medi-Share Christian Care $263 - $346 296%
Claim Watcher Plus $265 298%
Commercial Generic $277 - $364 312%
Highmark Commercial Non-Preferred $277 - $367 312%
Magellan $277 - $364 312%
United Behavioral Health $277 - $364 312%
Value Options $277 - $364 312%
Workers Compensation $277 - $364 312%
Claim Watcher $292 328%
Elap Other Groups $322 362%
Gift Of Life Donor Program $13,500 15184%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals