CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: PAM Specialty Hospital of Denver

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $3,519
Cash Discount Price: $4,399
vs. Medicare Baseline: 39.58x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at PAM Specialty Hospital of Denver is $3,519. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,399. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 39.58x the Medicare baseline. Located in 1690 N Meade St, Denver, CO.

Cash / Self-Pay

$4,399

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,519

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: $4,399 (4948%)

Insurance Median: $3,519 (3958%)

Cash: $4,399 (4948% of Medicare)

Ins. Median: $3,519 (3958% 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 3958% of the Medicare baseline (a markup of 3858%). 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
Galaxy Health Network	$2,859	3216%
America'S Choice	$3,079	3463%
Provider Network Of America	$3,299	3710%
Quik Trip	$3,299	3710%
Usa Managed Care Organization	$3,299	3710%
Velocity Provider Ppo Network	$3,299	3710%
Evolutions Healthcare System	$3,519	3958%
Fara	$3,519	3958%
Multiplan	$3,519	3958%
Integrated Health Plan	$3,607	4057%
First Choice Of The Midwest	$3,739	4205%
Fortified Provider Network	$3,739	4205%
Prime Health Services	$3,739	4205%
Three Rivers Provider Network	$3,739	4205%

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 $4,399.
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 PAM Specialty Hospital of Denver 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.