CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $945
Cash Discount Price: $2,952
vs. Medicare Baseline: 10.63x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Central Florida Lake Monroe Hospital is $945. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,952. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 10.63x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.

Cash / Self-Pay

$2,952

Average discount available for prompt cash payment at this facility.

Insurance Median

$945

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: $2,952 (3320%)

Insurance Median: $945 (1063%)

Cash: $2,952 (3320% of Medicare)

Ins. Median: $945 (1063% 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 1063% of the Medicare baseline (a markup of 963%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
United	$182 - $1,328	205%
Freedom Health	$213	240%
Optimum	$213	240%
Corvel Corporation	$416	468%
Prime Health	$425	478%
Careworks (Rockport Community)	$438	493%
Simply	$455	512%
Molina Healthcare	$561 - $945	631%
Humana	$590	664%
Evolutions	$679	764%
Avmed	$708 - $1,476	796%
Sunshine State Health Plan	$753	847%
Aetna	$886	997%
Florida Health Care Plan	$1,113	1252%
Plotkin Health	$1,476	1660%
Prime Health Sheriff	$1,476	1660%
Multiplan	$2,214 - $2,509	2490%
Three Rivers Provider Network	$2,214	2490%
Ppo Next	$2,509	2822%
Novanet	$2,657	2988%

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 $2,952.
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 Central Florida Lake Monroe 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.