CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Excela Health - Frick Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $94
Cash Discount Price: $150
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Excela Health - Frick Hospital is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.06x the Medicare baseline. Located in 508 South Church Street, Mount Pleasant, PA.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$94

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: $150 (169%)

Insurance Median: $94 (106%)

Cash: $150 (169% of Medicare)

Ins. Median: $94 (106% 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
Upmc For Kids Chip	$24	27%
Geisinger	$32 - $93	36%
Health Partners Plans	$32	36%
Highmark Wholecare	$33 - $97	37%
Amerihealth Caritas	$34 - $93	38%
Pa Health And Wellness	$34 - $95	38%
Upmc	$34 - $96	38%
Highmark Advantage Community Blue	$83	93%
Senior Life	$89	100%
Va	$89	100%
Aetna	$92 - $204	103%
Health Partners Plan	$92	103%
Humana	$92	103%
Martin'S Point	$92	103%
Peak Health	$92 - $209	103%
The Health Plan Of West Virginia	$92 - $209	103%
United	$92	103%
Cigna	$93 - $196	105%
Devoted	$93	105%
American Health Plan Of Pa	$98	110%
Provider Network Of America	$98 - $200	110%
Provider Plan Partners Plan	$98	110%
Upmc Health Plan	$103 - $104	116%
Highmark Children'S Health Insurance Program	$107	120%
Ambetter / Centene	$111	125%
Highmark	$120 - $196	135%
Velocity	$133	150%
Community Blue	$177	199%
UnitedHealthcare	$227	255%

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 $150.
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 Excela Health - Frick 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.