CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mayers Memorial Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $173
Cash Discount Price: $216
vs. Medicare Baseline: 1.95x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mayers Memorial Hospital is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.95x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.

Cash / Self-Pay

$216

Average discount available for prompt cash payment at this facility.

Insurance Median

$173

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: $216 (243%)

Insurance Median: $173 (195%)

Cash: $216 (243% of Medicare)

Ins. Median: $173 (195% 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
Blue Shield Ca Va	$10 - $157	11%
Blue Shield Mcr Adv	$10 - $157	11%
Tricare	$10 - $165	11%
Arcadian Health Services-All Plans	$11 - $165	12%
Health Net Mcr Adv	$11 - $165	12%
Imperial Health Plan-All Plans	$12 - $187	13%
Medi-Cal	$26 - $37	29%
Partnership Hp-All Plans	$149	168%
Blue Cross Blue Shield	$167 - $214	188%
Cigna	$173 - $238	195%
Corvel Ppo-All Plans	$173 - $238	195%
Coventry/First Health-All Plans	$173 - $238	195%
Integrated Hp-All Plans	$173 - $238	195%
Interplan-All Plans	$173 - $238	195%
Health Net Prison	$180	202%
Blue Shield Ca Exchange	$214	241%
Blue Shield-All Other Plans	$238	268%
Hmn-All Plans	$238	268%
Multiplan Phcs-All Plans	$238	268%
Pfmc-All Plans	$238	268%
Superior Ca-All Plans	$238	268%
Health Net-All Other Plans	$249	280%
Pacificare-All Plans	$250	281%

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 $216.
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 Mayers Memorial 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.