CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Sonoma Valley Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $620
  • Cash Discount Price: $694
  • vs. Medicare Baseline: 6.97x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Sonoma Valley Hospital is $620. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $694. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.97x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$694

Average discount available for prompt cash payment at this facility.

Insurance Median
$620

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: $694 (781%)
Insurance Median: $620 (697%)
Cash: $694 (781% of Medicare)
Ins. Median: $620 (697% 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 697% of the Medicare baseline (a markup of 597%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $31 35%
First Health(Coventry)-All Plans $31 35%
Medi-Cal $37 42%
Mcal Mgd Care (Php)-All Plans $61 69%
Tricare $117 132%
Blue Cross Blue Shield $120 - $651 135%
Bright Hlth/Brand New Day Mcr Adv $120 135%
Hospice Of Marin-All Plans $120 135%
St Joseph Heritage Hltcare Comm-All Other Plans $120 135%
Veterans Admin-All Plans $120 135%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $126 142%
Partnership Healthplan-All Plans $130 146%
Cdcr Prison-All Plans $144 162%
Three Rivers (Trpn)-All Plans $144 162%
Chp - Correctional Health Partners - All Plans $156 175%
Bright Hlth/Brand New Day - All Other Plands $162 182%
Wellpath - All Plans $168 189%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $215 242%
Canopy Health Solutions-All Other Plans $215 242%
Healthnet Hmo/Ppo-All Other Plans $347 390%
Blue Shield Ppo-All Plans $563 633%
UnitedHealthcare $595 669%
Kaiser-All Plans $645 725%
Integrated Health Plan-All Plans $734 826%
Champus-All Plans $794 893%
Cigna $794 893%
Networks By Design - All Plans $794 893%
Comm Care Network(Ccn)-All Plans $843 948%
Great West-One Health Plan Ppo/Pos-All Plans $843 948%
Phcs/Multiplan/Beech St-All Plans $843 948%
Interplan-All Plans $873 982%
Bps-All Plans $893 1004%
Ppo Alliance-All Plans $893 1004%
Pref Health Networl(Phn)-All Plans $893 1004%
Meritage Medical Network Op Only Mcare $992 1116%
Scan Mcare-All Plans $992 1116%
St Joseph Heritage Hltcare Mcr Adv $992 1116%
Correct Care Integ Health-All Plans $1,190 1338%
Employer Direct Healthcare-All Plans $1,190 1338%
Meritage Medical Network Op Only-All Other Plans $1,250 1406%
Creative Legal Services-All Plans $1,290 1451%
Canopy Op Only $1,786 2009%
Vnpn - All Plans $1,786 2009%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals