CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Orthocolorado Hosp at St Anthony Med Campus

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $100
Cash Discount Price: $456
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Orthocolorado Hosp at St Anthony Med Campus is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $456. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.12x the Medicare baseline. Located in 11650 W 2Nd Pl, Lakewood, CO.

Cash / Self-Pay

$456

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $456 (513%)

Insurance Median: $100 (112%)

Cash: $456 (513% of Medicare)

Ins. Median: $100 (112% 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
Aetna	$29 - $100	33%
Blue Cross Blue Shield	$29 - $51	33%
Cigna	$29 - $127	33%
Devoted Health	$29	33%
Humana	$29	33%
Innovage	$29	33%
Kaiser	$29 - $314	33%
Medicare (plans)	$29	33%
UnitedHealthcare	$29 - $182	33%
Direct To Employer	$75 - $456	84%
Centura Employee Plan	$91	102%
Peak Health	$99 - $445	111%
Multiplan	$134 - $969	151%
United Colorado Doctor'S Plan	$182	205%
Denver Health	$269	303%

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 $456.
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 Orthocolorado Hosp at St Anthony Med Campus 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.