CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Highland Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $124
Cash Discount Price: $321
vs. Medicare Baseline: 1.39x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Highland Hospital is $124. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $321. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.39x the Medicare baseline. Located in 1411 East 31St Street, Oakland, CA.

Cash / Self-Pay

$321

Average discount available for prompt cash payment at this facility.

Insurance Median

$124

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: $321 (361%)

Insurance Median: $124 (139%)

Cash: $321 (361% of Medicare)

Ins. Median: $124 (139% 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.

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
Kaiser Medi-Cal Managed Care [1026106]	$17	19%
Alameda Alliance Commercial Alternate [4801]	$48	54%
Alameda Alliance Mgd Mcal Alternate [2801]	$48	54%
Alameda Alliance Non-Verified [1002303]	$48	54%
Alameda Alliance [1002106]	$48	54%
Alameda Alliance [1002206]	$48	54%
Mc Alameda Alliance Capitation [1002103]	$48	54%
Aetna	$96 - $393	108%
Blue Cross Blue Shield	$111 - $400	125%
Brown Toland Medical Group Alternate [1049301]	$111 - $124	125%
Brown Toland Medical Group [1049001]	$111 - $124	125%
Brown Toland Mgd Mcr Alternate [1802]	$111 - $124	125%
Health Net [1022001]	$111 - $433	125%
Medicare (plans)	$111 - $124	125%
UnitedHealthcare	$232 - $307	261%
Blue Shield [1006001]	$339 - $400	381%
Kaiser Commercial [1026001]	$417	469%
Cigna	$801	901%

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 $321.
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 Highland 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.