CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Shriners Hospitals for Children Northern Calif

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $56
Cash Discount Price: $294
vs. Medicare Baseline: 0.63x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Shriners Hospitals for Children Northern Calif is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $294. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.63x the Medicare baseline. Located in 2425 Stockton Boulevard, Sacramento, CA.

Cash / Self-Pay

$294

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

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: $294 (331%)

Insurance Median: $56 (63%)

Cash: $294 (331% of Medicare)

Ins. Median: $56 (63% 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
Ambetter / Centene	$22 - $130	25%
Amerigroup Nv	$23 - $35	26%
Blue Cross Blue Shield	$26 - $37	29%
Gateway Health Plan	$26	29%
Health Plan Of Nv	$26 - $39	29%
Soonercare	$33	37%
Aetna	$37 - $113	42%
Central California Alliance For Health	$37	42%
Health Plan Of San Joaquin	$37	42%
Kaiser Permanente	$37 - $100	42%
Molina Healthcare Of Ca	$37	42%
Partnership Healthplan Of Ca	$37	42%
Providence Health Plan	$51	57%
Medicaid / KanCare	$74	83%
Cigna	$75	84%
UnitedHealthcare	$80	90%
Molina Healthcare Of Ms	$85	96%
Amerihealth Caritas Nc	$98	110%
Amerihealth Caritas Sc	$98	110%
Caresource Of Oh	$98	110%
Northbay Healthcare	$113	127%
Sana Benefits	$119 - $158	134%
Sutter Medical Foundation	$124	139%
Health Net Of Ca	$130	146%
Healthchoice Of Oklahoma	$176	198%

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 $294.
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 Shriners Hospitals for Children Northern Calif 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.