CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: HCA Florida South Shore Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $841
Cash Discount Price: $3,524
vs. Medicare Baseline: 9.46x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at HCA Florida South Shore Hospital is $841. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,524. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 9.46x the Medicare baseline. Located in 4016 Sun City Center Blvd, Sun City Center, FL.

Cash / Self-Pay

$3,524

Average discount available for prompt cash payment at this facility.

Insurance Median

$841

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: $3,524 (3964%)

Insurance Median: $841 (946%)

Cash: $3,524 (3964% of Medicare)

Ins. Median: $841 (946% 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 946% of the Medicare baseline (a markup of 846%). 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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$156 - $175	175%
United	$182 - $1,673	205%
Access 2 Healthcare Physicians Freedom Health	$240 - $268	270%
Access 2 Healthcare Physicians Optimum	$240 - $268	270%
Freedom Health Care	$260 - $290	292%
Optimum Healthcare	$260 - $290	292%
Avmed	$266 - $930	299%
Corvel Corporation	$422	475%
Rockport Healthcare Group	$422	475%
Prime Health	$431	485%
Simply Healthcare	$513 - $573	577%
Molina	$632 - $1,004	711%
Evolutions Healthcare Systems	$766 - $3,421	862%
Sunshine State Health Plan	$849 - $948	955%
Humana	$932 - $1,041	1048%
Aetna	$999 - $1,116	1124%
Plotkin Health	$1,664 - $1,859	1872%
Prime Health Sheriff	$1,664 - $1,859	1872%
Multiplan	$2,497 - $3,161	2808%

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 $3,524.
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 HCA Florida South Shore 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.