CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Lower Keys Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $158
  • Cash Discount Price: $378
  • vs. Medicare Baseline: 1.78x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Lower Keys Medical Center is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $378. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.78x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$378

Average discount available for prompt cash payment at this facility.

Insurance Median
$158

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: $378 (425%)
Insurance Median: $158 (178%)
Cash: $378 (425% of Medicare)
Ins. Median: $158 (178% 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
Prime Health Work Comp Fl $49 55%
Fl Work Comp $51 57%
Heritage Summit Work Comp Fl $51 57%
Florida Childrens Medical Services $54 61%
Medicaid / KanCare $54 - $60 61%
South Florida Community Care Network $54 61%
Humana $56 - $96 63%
Amerigroup $60 67%
Positive Healthcare $60 67%
Simply Healthcare $60 - $378 67%
Wellcare $60 67%
Wellcare Healthease $60 67%
Molina $61 69%
UnitedHealthcare $62 - $937 70%
Prestige Health Choice $63 71%
Magellan $65 73%
Veterans Eval Services $83 93%
Tricare $92 103%
Blue Cross Blue Shield $96 - $1,218 108%
Medicare (plans) $96 108%
Ultimate Health $96 108%
Node Champva $97 109%
Node Non Par Hospice Agree $97 109%
Node United Behavioral Va Ccn $97 109%
Node Va $97 109%
Correct Care Solutions $107 120%
Node Us Dept Of Labor $122 137%
State Auto Insurance Fl $195 219%
Self Pay $329 - $426 370%
Cigna $719 809%
Aetna $850 956%
Monroe County $914 1028%
Evolutions Healthcare Systems $974 - $1,157 1095%
Keys Energy $974 1095%
Prime Health Ppo $974 1095%
Avmed Health Plan $1,035 1164%
Direct Healthcare $1,218 1370%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals