CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: West Kendall Baptist Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $388
  • Cash Discount Price: $663
  • vs. Medicare Baseline: 4.36x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at West Kendall Baptist Hospital is $388. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $663. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.36x the Medicare baseline. Located in 9555 Sw 162 Ave, Miami, FL.
Cash / Self-Pay
$663

Average discount available for prompt cash payment at this facility.

Insurance Median
$388

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: $663 (746%)
Insurance Median: $388 (436%)
Cash: $663 (746% of Medicare)
Ins. Median: $388 (436% 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 436% of the Medicare baseline (a markup of 336%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Amerigroup $34 38%
Medicaid / KanCare $34 - $38 38%
Sunshine State $36 40%
UnitedHealthcare $36 - $1,020 40%
Wellcare $36 40%
Aetna $37 - $816 42%
Vista $37 42%
Medicare (plans) $91 - $123 102%
Blue Cross Blue Shield $94 - $661 106%
Medica Health Plan $97 109%
Humana $99 111%
Avmed $100 - $497 112%
Leon Medical $102 115%
Cigna $104 - $816 117%
Non Contracted $374 421%
Amerihealth $459 516%
International $663 746%
Dimension Health Plan $765 - $918 860%
Affordable $918 1033%
Phcs $918 1033%
Quality Health $918 1033%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9555 Sw 162 Ave, Miami, FL 33196
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals