CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: City of Hope National Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $337
Cash Discount Price: $449
vs. Medicare Baseline: 3.79x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at City of Hope National Medical Center is $337. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $449. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.79x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$449

Average discount available for prompt cash payment at this facility.

Insurance Median

$337

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: $449 (505%)

Insurance Median: $337 (379%)

Cash: $449 (505% of Medicare)

Ins. Median: $337 (379% 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 379% of the Medicare baseline (a markup of 279%). 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
Health Net	$17 - $436	19%
Cal Optima	$24 - $36	27%
Heritage Provider Network	$32 - $314	36%
Inland Empire	$37 - $359	42%
Prime Healthcare Keenan	$59 - $431	66%
Blue Cross Blue Shield	$172 - $314	193%
UnitedHealthcare	$251 - $380	282%
Blue Shield	$266 - $535	299%
Blue Shield Covca	$273	307%
Blue Shield Promise	$314	353%
Cencal	$359	404%
La Care Health	$359	404%
Kaiser	$404	454%
Cigna	$425	478%
Aetna	$449	505%
Gold Coast	$449	505%
Molina	$449 - $584	505%
Facey	$494	556%
Healthcare Partners	$521	586%
St. Joseph Heritage	$539	606%
Primecare Medical Network	$584	657%
First Health	$691	777%
Phcs Multiplan	$808	909%

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 $449.
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 City of Hope National Medical Center 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.