CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Children's Hospital of Philadelphia

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $650
Cash Discount Price: $1,547
vs. Medicare Baseline: 7.31x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Children's Hospital of Philadelphia is $650. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,547. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 7.31x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$1,547

Average discount available for prompt cash payment at this facility.

Insurance Median

$650

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: $1,547 (1740%)

Insurance Median: $650 (731%)

Cash: $1,547 (1740% of Medicare)

Ins. Median: $650 (731% 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 731% of the Medicare baseline (a markup of 631%). 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
Geisinger Medical Assistance	$22	25%
Highmark Wholecare	$25	28%
Horizon Nj Health	$64	72%
Medicaid / KanCare	$255	287%
UnitedHealthcare	$257 - $851	289%
Health Partners	$292	328%
Aetna	$407 - $774	458%
Upmc Medical Assistance	$422	475%
Keystone First Chip	$480	540%
Keystone Health Plan East	$489	550%
Blue Cross Blue Shield	$546 - $620	614%
Geisinger Health Plan Commercial	$681	766%
Jefferson Health Plans	$732	823%
Cigna	$774	871%
Highmark	$774	871%
Qualcare	$851	957%
First Health Network	$1,006	1131%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$1,238	1392%
Private Health Care Systems	$1,238	1392%
Choice Care Network	$1,392	1566%

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 $1,547.
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 Children's Hospital of Philadelphia 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.