CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Adventist Health Sierra Vista

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $854
Cash Discount Price: $155
vs. Medicare Baseline: 9.61x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Adventist Health Sierra Vista is $854. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $155. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 9.61x the Medicare baseline. Located in 1010 Murray St, San Luis Obispo, CA.

Cash / Self-Pay

$155

Average discount available for prompt cash payment at this facility.

Insurance Median

$854

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: $155 (174%)

Insurance Median: $854 (961%)

Cash: $155 (174% of Medicare)

Ins. Median: $854 (961% 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 961% of the Medicare baseline (a markup of 861%). 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
Aetna	$112	126%
Cencal Mcr Adv - All Other Plans	$112	126%
Tricare	$112	126%
UnitedHealthcare	$112 - $668	126%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$145	163%
Ah Employee Health Plan - All Plans	$201	226%
Blue Shield Epn	$622 - $761	700%
Hpn-Heritage Prov Ntwrk-All Plans	$630	709%
Blue Shield Hmo/Pos	$775 - $904	872%
Blue Shield Epo/Ppo-All Other Plans	$854 - $1,044	961%
Nbd-Ntwrks By Design Non-Exclus	$917 - $1,121	1031%
Nbd-Ntwrks By Design Exclus-All Other Plans	$1,070 - $1,121	1203%
Medi-Cal	$1,588 - $1,852	1786%
Cencal Mcal	$1,810 - $2,213	2036%
Blue Shield Promise Mcal	$1,909 - $2,333	2147%
Coalinga-All Plans	$2,064 - $2,523	2321%
Ccah-Centrl Ca Allince Mcal-All Plans	$2,408 - $2,523	2708%

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 $155.
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 Adventist Health Sierra Vista 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.