CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Valley Presbyterian Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $240
Cash Discount Price: $400
vs. Medicare Baseline: 2.70x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Valley Presbyterian Hospital is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $400. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.70x the Medicare baseline. Located in 15107 Vanowen St, Van Nuys, CA.

Cash / Self-Pay

$400

Average discount available for prompt cash payment at this facility.

Insurance Median

$240

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: $400 (450%)

Insurance Median: $240 (270%)

Cash: $400 (450% of Medicare)

Ins. Median: $240 (270% 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 270% of the Medicare baseline (a markup of 170%). 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
Blue Cross Blue Shield	$54 - $112	61%
Blue Shield Ifp	$86	97%
Aetna	$93 - $112	105%
Blue Shield Promise Medi-Cal	$94 - $123	106%
Blue Shield	$102	115%
Blue Shield Senior	$110	124%
Health Net Senior	$112	126%
La Care Covered California	$112	126%
Medicare (plans)	$112 - $117	126%
UnitedHealthcare	$115 - $382	129%
Ambetter / Centene	$158	178%
Heritage Provider Network (Regal & Lakeside)	$173	195%
Health Net	$221	249%
La Care Medi-Cal	$224 - $295	252%
Phcs	$224 - $295	252%
Coventry Health Care (Ccn)	$262 - $344	295%
Beech Street	$280 - $368	315%
Multiplan	$337 - $442	379%
Cigna	$498	560%

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 $400.
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 Valley Presbyterian Hospital 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.