CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: UPMC Wellsboro

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $645
Cash Discount Price: $704
vs. Medicare Baseline: 7.25x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at UPMC Wellsboro is $645. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $704. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 7.25x the Medicare baseline. Located in 32-36 Central Avenue, Wellsboro, PA.

Cash / Self-Pay

$704

Average discount available for prompt cash payment at this facility.

Insurance Median

$645

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: $704 (792%)

Insurance Median: $645 (725%)

Cash: $704 (792% of Medicare)

Ins. Median: $645 (725% 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 725% of the Medicare baseline (a markup of 625%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
UnitedHealthcare	$21 - $903	24%
Amerihealth Caritas	$29	33%
Geisinger	$29 - $712	33%
Upmc Health Plan	$29 - $463	33%
Highmark Wholecare (Prev Gateway)	$30 - $212	34%
Health Partners Plans (Jefferson Health Plan)	$40	45%
Pa Health & Wellness	$45 - $229	51%
Upmc Work Partners	$79	89%
Aetna	$173 - $917	195%
Blue Cross Blue Shield	$193 - $537	217%
Cigna	$202 - $223	227%
Wirerope Works	$535 - $590	602%
Multiplan	$751 - $1,009	845%
America'S Choice	$867 - $956	975%
Intergroup	$867 - $956	975%

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 $704.
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 UPMC Wellsboro 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.