CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Lehigh Valley Hospital - Pocono

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $97
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.09x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Lehigh Valley Hospital - Pocono is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.09x the Medicare baseline. Located in 206 East Brown Street, East Stroudsburg, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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%)
Insurance Median: $97 (109%)
Ins. Median: $97 (109% 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
Amerihealth Caritas $29 33%
Geisinger $29 - $218 33%
UnitedHealthcare $30 - $96 34%
Aetna $34 - $509 38%
Highmark Wholecare/Gateway $34 38%
Jefferson Health Partners $36 - $184 40%
Pa Health & Wellness $36 40%
Upmc $44 - $447 49%
Highmark Blue Shield $94 - $410 106%
Amerihealth $95 107%
Cigna $95 107%
Devoted Health $97 109%
Humana $97 109%
Gateway $98 110%
Emblem $99 - $531 111%
Pa Health & Wellness (Allwell) $101 114%
Ambetter / Centene $279 314%
Valley Preferred $536 603%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 206 East Brown Street, East Stroudsburg, PA 18301
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals