CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Hialeah Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $87
  • Cash Discount Price: $738
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Hialeah Hospital is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $738. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.98x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$738

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

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: $738 (830%)
Insurance Median: $87 (98%)
Cash: $738 (830% of Medicare)
Ins. Median: $87 (98% 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.

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 $16 - $531 18%
Dimension Health Wc $29 33%
Workers Compensation $29 33%
Avmed Broad Network $33 37%
Humana $36 - $170 40%
Medicaid / KanCare $36 - $37 40%
UnitedHealthcare $36 - $85 40%
Healthsun Health Plans $42 - $89 47%
Imagine Health $46 52%
Employer Direct Healthcare $50 - $87 56%
Self Pay/Uninsured $50 - $107 56%
Oscar Health Plan Hix $57 64%
Veterans Administration Mill Bill $60 67%
Medicare (plans) $77 - $186 87%
Devoted Health $85 96%
Leon Health Inc $85 96%
Tricare $86 97%
Bristol Hospice- Miami Dade Llc $87 98%
Catholic Hospice $87 98%
Comprehensive Home Health Care Dba Opuscare Of South Florida $87 98%
Hcr Manor Care Services Of Fl $87 98%
Hospice Other $87 98%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $87 98%
Seasons Hospice And Pallative Care Of Southern Florida Inc $87 98%
Veterans Administration Vaccn $87 98%
Vitas Healthcare Hospice Corporation Of Fl $87 98%
Vitas Hospice Unit Agreement $87 98%
Cigna $89 - $217 100%
Longevity Health Plan $91 102%
Florida Pace Centers $102 115%
Bright Health Management Commercial $104 117%
Naphcare Inc $119 134%
Bc/Bs Myblue Hmo Hix $146 164%
Bc/Bs Of Fl Miami Dade Blue Select $148 166%
Avmed Exchange $152 171%
Bc/Bs Of Fl Simplyblue $154 173%
Ambetter / Centene $160 180%
Molina Marketplace Program Exchange $165 186%
Auto Insurance $173 195%
Avmed Select Network $177 199%
Amerihealth Caritas Next Exchange $186 209%
Bc/Bs Of Fl Network Blue $192 216%
Bc/Bs Of Fl Health Options Hmo $197 222%
Bc/Bs Of Fl Ppo $203 228%
Bc/Bs Of Fl Blue Select Exchange Non Par $214 241%
Bc/Bs Of Fl Phs $383 431%
Dimensions International $480 540%
First Health $502 565%
Dimension Health Ppo $553 622%
Commercial Non-Contracted $738 830%
Self Pay - Mcd Pending 100 Percent $738 830%
Single Case Agreement $738 830%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals