CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Adventist Health Tulare

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $49
  • Cash Discount Price: $77
  • vs. Medicare Baseline: 0.55x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Adventist Health Tulare is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.55x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.
Cash / Self-Pay
$77

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $77 (87%)
Insurance Median: $49 (55%)
Cash: $77 (87% of Medicare)
Ins. Median: $49 (55% 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.

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
Blue Shield Mcare $11 - $112 12%
Fhcn Pace Mcr Adv - All Plans $11 - $112 12%
Medicare (plans) $11 - $112 12%
Tricare $11 - $112 12%
UnitedHealthcare $11 - $560 12%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot $11 12%
Ah Employee Health Plan - All Plans $12 - $201 13%
Incentive Hlth - All Plans $12 - $201 13%
Hs Interplan-All Plans $13 - $518 15%
Blue Cross Blue Shield $14 - $176 16%
Cal Forensic Med Grp - All Plans $14 - $146 16%
Cigna $14 - $358 16%
Blue Shield Epn $15 - $244 17%
Healthnet Hmo/Ppo - All Other Plans $15 - $298 17%
Blue Shield-All Other Plans $16 - $338 18%
Aetna $25 - $156 28%
Ccipa Medi-Cal - All Plans $26 - $48 29%
Healthnet Medi-Cal $26 - $49 29%
Medi-Cal $26 - $37 29%
Upn-United Physcn Ntwrk Mcal Profee Only $26 29%
Dignity Mcal Op Only $41 46%
Independence Op Only - All Plans $41 46%
Dignity Mcr Op Only - All Other Plans $112 126%
Prime Health - All Plans $112 126%
Prison Hlthcre - All Plans $143 161%
Bright Health - All Plans $162 182%
Western Growers - All Plans $356 400%
Network By Design-All Plans $541 608%
Multiplan - All Plans $657 739%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 869 North Cherry Street, Tulare, CA 93274
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals