CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $62
Cash Discount Price: $259
vs. Medicare Baseline: 0.70x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Cleveland Clinic Indian River Hospital is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $259. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.70x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.

Cash / Self-Pay

$259

Average discount available for prompt cash payment at this facility.

Insurance Median

$62

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: $259 (291%)

Insurance Median: $62 (70%)

Cash: $259 (291% of Medicare)

Ins. Median: $62 (70% 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	$8 - $562	9%
Avmed	$11 - $202	12%
Blue Cross Blue Shield	$11 - $572	12%
Careplus	$11 - $88	12%
Clear Spring Health	$11 - $56	12%
Freedom Health	$11 - $88	12%
Independent Living Systems	$11 - $93	12%
Magellan	$11 - $422	12%
United	$11 - $88	12%
Value Options	$11	12%
Wellcare	$11 - $88	12%
Wellmed	$11 - $88	12%
Cigna	$13 - $211	15%
Clarity Health	$62 - $457	70%
The Legacy Companies	$62 - $457	70%
National Provider Network	$66	74%
Three Rivers	$66	74%
Consociate Health	$71	80%
Carelon Bh Strategies	$88	99%
Humana	$88	99%
Devoted Health	$97	109%
Bmi	$387	435%
Multiplan	$562	632%

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 $259.
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 Cleveland Clinic Indian River 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.