CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: San Antonio Regional Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $270
  • Cash Discount Price: $281
  • vs. Medicare Baseline: 3.04x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at San Antonio Regional Hospital is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $281. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.04x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$281

Average discount available for prompt cash payment at this facility.

Insurance Median
$270

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: $281 (316%)
Insurance Median: $270 (304%)
Cash: $281 (316% of Medicare)
Ins. Median: $270 (304% 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 304% of the Medicare baseline (a markup of 204%). 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
Medi-Cal $37 42%
Healthnet Medi-Cal $39 44%
Kaiser Medi-Cal $39 44%
Alpha Care Mg Mcal/Hlthy Kids $41 46%
Heritage Prov Ntwrk/Regal Mcal $41 46%
Molina Medi-Cal $43 48%
Blue Cross Blue Shield $44 - $730 49%
Iehp Mcal $48 54%
Aetna $59 - $1,344 66%
Blue Shield Epn $98 110%
Tricare $110 124%
Blue Shield Mcr Adv $112 126%
Caremore Mcr Adv - All Plans $112 126%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $112 126%
Healthnet Mcr Adv $112 126%
Humana $112 126%
Iehp Mcr Adv $112 126%
Inter Valley Hp Mcr Adv- All Plans $112 126%
Kindred Mcr Adv-All Plans $112 126%
Molina Mcr Adv $112 126%
Scan Health Plan Mcr Adv-All Plans $112 126%
Universal Care - All Plans $112 126%
Zelis Mcr Adv $118 133%
Kasiser Mcr Adv $120 135%
Imperial Health Mcr Adv-All Plans $123 138%
Choice Phycn Ntwrk Op Only $140 157%
Molina Exchange-All Other Plans $146 164%
Iehp Comm - All Other Plans $162 182%
Redlands Employee $168 189%
Redlands Hmo-All Other Plans $175 197%
Prime Health - All Plans $196 220%
Ambetter / Centene $245 276%
Healthnet - All Other Plans $268 301%
UnitedHealthcare $272 - $511 306%
Kaiser Comm - All Other Plans $312 351%
Epic Health Plan - All Other Plans $403 453%
Blue Shield Hmo Pos / Calpers Ppo $485 545%
Blue Shield Epo Ppo - All Other Plans $521 586%
Cigna $528 594%
Pc Inland Valley Scan $672 756%
Pc Inland Valley-All Other Plans $672 756%
Coventry Ccn/First Hlth - All Plans $739 831%
Choicecare Ntwrk-All Plans $968 1089%
Multiplan/Phcs - All Plans $968 1089%
Networks By Design - All Plans $1,008 1134%
Zelis Comm-All Other Plans $1,008 1134%
Foundation Inland Epo-All Other Plans $1,075 1209%
Foundation Inland Ppo $1,142 1284%
Health Payors - All Plans $1,210 1361%
Interplan - All Plans $1,210 1361%
Wellcare/Easy Choice-All Plans $1,317 1481%
Alpha Care Mg Mcr Adv $1,344 1512%
Central Hlth Plan Mcr Adv-All Plans $1,344 1512%
Epic Health Plan Mcr Adv $1,344 1512%
Prospect Hp-All Plans $1,344 1512%
Providence Clevercare Mcr Adv $1,344 1512%
Heritage Prov Ntwrk/Regal Mcr Adv $1,364 1534%
Clever Care Mcr Adv - All Plans $1,411 1587%
La Salle Hp Mcr Adv-All Plans $1,411 1587%
Providence Oscar-All Other Plans $1,411 1587%
Alpha Care Mg-All Other Plans $1,680 1890%
Heritage Prov Ntwrk/Regal - All Other Plans $2,470 2778%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals