CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: St Francis Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $184
  • Cash Discount Price: $323
  • vs. Medicare Baseline: 2.07x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at St Francis Hospital is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $323. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.07x the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.
Cash / Self-Pay
$323

Average discount available for prompt cash payment at this facility.

Insurance Median
$184

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: $323 (363%)
Insurance Median: $184 (207%)
Cash: $323 (363% of Medicare)
Ins. Median: $184 (207% 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 207% of the Medicare baseline (a markup of 107%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Delaware First Health $82 92%
Pace-Trinity Health $91 102%
Saint Francis Life $91 102%
Blue Cross Blue Shield $93 - $233 105%
Cigna $94 - $308 106%
Blue Shield - De (Highmark) Medciare Advantage $95 107%
Highmark Health Options Dual Plan $95 107%
Medicare (plans) $95 - $97 107%
Aetna $98 - $323 110%
Coventry $111 125%
Medicaid / KanCare $174 196%
Blue Benefit Administrators Of Massachusetts $184 207%
Blue Care Network $184 207%
Blue Distinction Transplant $184 207%
Blue Shield - Ca $184 207%
Blue Shield - Id (Regence) $184 207%
Blue Shield - Ny Highmark Northeastern $184 207%
Blue Shield - Ny Highmark Western $184 207%
Blue Shield - Pa (Highmark) $184 207%
Blue Shield - Wa (Regence) $184 207%
Amerihealth $233 262%
Meritain $323 363%
Trustmark Small Business Benefits $323 363%
Devon Health Services $472 531%
Galaxy Health Network $472 531%
Multiplan $472 531%
Prime Health Services $472 531%
Three Rivers Provider Network $472 531%
Wc Corvel $472 531%
Geha $477 536%
UnitedHealthcare $477 536%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7Th and Clayton Sts, Wilmington, DE 19805
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals