CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Grandview Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $495
  • Cash Discount Price: $288
  • vs. Medicare Baseline: 5.57x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Grandview Medical Center is $495. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $288. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.57x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$288

Average discount available for prompt cash payment at this facility.

Insurance Median
$495

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: $288 (324%)
Insurance Median: $495 (557%)
Cash: $288 (324% of Medicare)
Ins. Median: $495 (557% 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 557% of the Medicare baseline (a markup of 457%). 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 $22 25%
Encompass Health $27 30%
Tricare $68 - $76 76%
Blue Advantage $70 - $78 79%
Humana $70 - $78 79%
Medicare (plans) $70 - $78 79%
UnitedHealthcare $70 - $707 79%
Victory Health $70 - $78 79%
Viva Health $70 - $865 79%
Select Health $71 - $79 80%
Cigna $72 - $141 81%
Hospice $72 - $80 81%
Node Champva $72 - $80 81%
Node Clover Health Mcr Adv $72 - $80 81%
Node Devoted Health Mcr Adv $72 - $80 81%
Node Va $72 - $80 81%
Aetna $73 - $437 82%
Node Wellcare Mcr Adv $73 - $81 82%
Veterans Eval Services $76 85%
Node Us Dept Of Labor $90 - $100 101%
Blue Cross Blue Shield $99 111%
Ambetter / Centene $107 - $119 120%
Healthspring $125 - $139 141%
Self Pay $212 - $377 238%
Bp Health Advocate $354 - $393 398%
Ag Administrators $495 - $550 557%
Alamed $495 - $550 557%
Choicecare $495 - $550 557%
Drummond $495 - $550 557%
American Employee Alliance $566 - $629 637%
Healthchoice $708 - $943 796%
Value Options $708 - $786 796%
First Health $849 - $1,229 955%
Multiplan $863 - $1,100 971%
Blue Bell Creameries $990 - $1,100 1113%
Natl Comp Care $1,061 - $1,179 1193%
Usa Ppo $1,061 - $1,179 1193%
Coventry Work Comp Al $1,107 - $1,229 1245%
Novanet $1,143 - $1,269 1286%
Alabama Wc $1,203 - $1,336 1353%
Cal-Med $1,203 - $1,336 1353%
Corvel $1,203 - $1,336 1353%
Associated Admin $1,274 - $1,415 1433%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals