CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Medstar Washington Hospital Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $166
Cash Discount Price: $340
vs. Medicare Baseline: 1.87x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Medstar Washington Hospital Center is $166. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $340. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.87x the Medicare baseline. Located in 110 Irving Street Nw, Washington, DC.

Cash / Self-Pay

$340

Average discount available for prompt cash payment at this facility.

Insurance Median

$166

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: $340 (382%)

Insurance Median: $166 (187%)

Cash: $340 (382% of Medicare)

Ins. Median: $166 (187% 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
Carefirst Advantage Inc	$103	116%
Tricare	$103	116%
UnitedHealthcare	$103 - $487	116%
Aetna	$105 - $106	118%
Kaiser Permanente	$105 - $262	118%
Health Care Service Corporation	$108	121%
Humana	$108	121%
Amerigroup	$120	135%
Amerihealth Caritas District Of Columbia	$120	135%
Hscsn	$120	135%
Medstar Family Choice Inc	$120 - $147	135%
Carefirst Blue Choice Inc	$166	187%
Cigna	$208	234%
Pfc	$340	382%
Ncppo Healthlink Ppo	$393	442%
Mamsi	$400	450%
Private Healthcare Systems (Phcs)	$419	471%
First Health	$445	501%

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 $340.
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 Medstar Washington Hospital Center 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.