CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Gaylord Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $65
Cash Discount Price: $180
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Gaylord Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $180. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.73x the Medicare baseline. Located in 50 Gaylord Farm Rd, Wallingford, CT.

Cash / Self-Pay

$180

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $180 (202%)

Insurance Median: $65 (73%)

Cash: $180 (202% of Medicare)

Ins. Median: $65 (73% 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	$11 - $191	12%
Blue Cross Blue Shield	$11 - $230	12%
Connecticare	$11 - $235	12%
UnitedHealthcare	$11 - $228	12%
Multiplan	$221	249%
Cigna	$222	250%
Harvard Pilgrim	$235	264%
Yale Health Plan	$252	283%

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 $180.
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 Gaylord 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.