CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Loma Linda University Children's Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $183
Cash Discount Price: $358
vs. Medicare Baseline: 2.06x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Loma Linda University Children's Hospital is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $358. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.06x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$358

Average discount available for prompt cash payment at this facility.

Insurance Median

$183

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: $358 (403%)

Insurance Median: $183 (206%)

Cash: $358 (403% of Medicare)

Ins. Median: $183 (206% 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 206% of the Medicare baseline (a markup of 106%). 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
Inland Empire Health Plan (Iehp)	$44 - $112	49%
Kaiser Foundation Hospitals	$49 - $531	55%
Alpha Care Medical Group	$112 - $168	126%
Dignity Health	$112 - $168	126%
Epic Health Plan	$112 - $318	126%
Upland Medical Group	$112	126%
Vantage Medical Group	$112 - $168	126%
UnitedHealthcare	$115	129%
Molina Healthcare Of Ca	$141 - $150	159%
Adventist Health	$159	179%
Blue Cross Blue Shield	$170	191%
Heritage Provider Network	$183	206%
Lluh Dept Of Risk Management	$191	215%
Blue Shield Of California	$322 - $487	362%
Global Benefits Group	$478	538%
Temecula Valley Physicians Medical Group	$478	538%
Trivalley Medical Group	$478	538%
Cigna	$509 - $589	572%
Networks By Design	$517	581%
Aetna	$522	587%
Multiplan	$637	716%
Galaxy Health	$677	761%
Prime Health Services	$677	761%

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 $358.
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 Loma Linda University Children's 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.