CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $213
  • Cash Discount Price: $537
  • vs. Medicare Baseline: 2.40x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Hospital of Univ of Pennsylvania is $213. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $537. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.40x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$537

Average discount available for prompt cash payment at this facility.

Insurance Median
$213

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: $537 (604%)
Insurance Median: $213 (240%)
Cash: $537 (604% of Medicare)
Ins. Median: $213 (240% 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 240% of the Medicare baseline (a markup of 140%). 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 - $537 18%
Kaiser Permanente $17 - $537 19%
Keystone Mercy Health Plan $21 - $537 24%
Upmc $25 - $537 28%
Pa Medical Assistance $26 - $537 29%
Health Partners $27 - $537 30%
UnitedHealthcare $33 - $537 37%
Blue Cross Blue Shield $37 - $470 42%
Keystone Hmo Proactive $37 42%
Ibc Commercial Hpn $39 44%
Paired Kidney Exchange $43 48%
Gspp And Wissahickon Hospice $46 52%
Cigna $77 - $242 87%
Horizon Nj Health $91 - $94 102%
Medicare (plans) $91 - $93 102%
Philadelphia Va Medical Center $91 102%
Tricare $91 102%
Ibc $93 105%
Geisinger Health Plan $94 - $290 106%
Humana $94 - $430 106%
Devoted Health $96 108%
Pa Health And Wellness $96 - $151 108%
Penn Life (Living Independently For Elders) $96 108%
Aetna $97 - $537 109%
Clover Health Plan $99 111%
Keystone First $102 115%
Us Family Health Plan $105 118%
Gateway Health Plan $113 127%
Preferred Health Care Eliance $118 133%
Pgm - Regie De L'Assurance Maladie Quebec $124 139%
Elap $130 146%
Claims Watcher $146 - $165 164%
Oscar Health Plan $156 175%
Centivo $165 186%
Elap Services $170 191%
Pgm - Kuwait Defense $188 - $242 211%
Highmark $192 216%
Qualcare $204 229%
Olympus $211 237%
Coventry $215 - $274 242%
Pgm - Chop $215 242%
Wissahickon Hospice $215 242%
Healthamerica/Coventry $242 - $263 272%
Penn Global Medicine $242 272%
First Health Global $268 301%
Health Net $322 362%
Pgm - Royal Embassy Of Saudi Arabia $322 362%
Pgm - Embassy Of Qatar $349 393%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $349 393%
Interlink $360 405%
Pgm - Embassy Of The United Emirates/Ipc $376 423%
Health America/Ccn $430 484%
Intergroup $430 484%
Pgm - Kuwait Health Division $430 484%
Pgm - Kuwait Oil $430 484%
Preferred Care $430 484%
Blue Quality Centers For Transplant (Bqct) $537 604%
City Of Philadelphia Behavioral Health $537 604%
Commercial Other $537 604%
International Pfs $537 604%
United Behavioral Health $537 604%
Workers Compensation $537 604%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals