CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Los Robles Hospital & Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $401
Cash Discount Price: $2,230
vs. Medicare Baseline: 4.51x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Los Robles Hospital & Medical Center is $401. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,230. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.51x the Medicare baseline. Located in 215 W Janss Rd, Thousand Oaks, CA.

Cash / Self-Pay

$2,230

Average discount available for prompt cash payment at this facility.

Insurance Median

$401

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: $2,230 (2508%)

Insurance Median: $401 (451%)

Cash: $2,230 (2508% of Medicare)

Ins. Median: $401 (451% 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 451% of the Medicare baseline (a markup of 351%). 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
Brand New Day	$27	30%
Gold Coast Health Plan	$27	30%
Blue Cross Blue Shield	$52 - $217	58%
Medcare Partners	$67 - $361	75%
Aetna	$79 - $2,408	89%
United	$125 - $677	141%
Health Net	$181 - $980	204%
Blue Shield	$298 - $426	335%
First Health	$303 - $1,927	341%
Choicecare Network	$312 - $1,686	351%
Cigna	$350	394%
Multiplan	$357 - $2,288	402%
Ppo Next	$357 - $1,927	402%
Interplan Corporation	$401 - $2,167	451%
Ventura County Foundation	$401 - $2,167	451%

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 $2,230.
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 Los Robles Hospital & 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.