CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Adventist Health and Rideout

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $708
  • Cash Discount Price: $220
  • vs. Medicare Baseline: 7.96x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Adventist Health and Rideout is $708. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $220. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 7.96x the Medicare baseline. Located in 726 4Th St, Marysville, CA.
Cash / Self-Pay
$220

Average discount available for prompt cash payment at this facility.

Insurance Median
$708

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: $220 (247%)
Insurance Median: $708 (796%)
Cash: $220 (247% of Medicare)
Ins. Median: $708 (796% 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 796% of the Medicare baseline (a markup of 696%). 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
Bc Mcal $13 15%
Kaiser Mcal $37 42%
Medi-Cal $37 42%
Ca Health And Wellness- All Plans $46 52%
Celtic Mcaid-All Plans $46 52%
Kaiser Mcr Adv $112 126%
Tricare $112 126%
UnitedHealthcare $112 - $869 126%
Blue Cross Blue Shield $113 - $771 127%
Healthnet Mcal $200 225%
Ah Employee Health Plan - All Plans $202 227%
Healthnet Comm-All Other Plans $644 724%
Aetna $708 796%
Kaiser-All Other Plans $761 856%
Blue Shield Uc Care Members $801 901%
Cigna $853 959%
First Health-All Plans $876 985%
Phcs-All Plans $881 991%
Interplan-All Plans $901 1013%
Blue Shield-All Other Plans $951 1070%
Multiplan-All Plans $951 1070%
Partnership Hp Mcal -All Plans $1,652 1858%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 726 4Th St, Marysville, CA 95901
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Federal
  • Hospital Type: Acute Care Hospitals