CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Baycare Hospital Wesley Chapel

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $387
Cash Discount Price: $595
vs. Medicare Baseline: 4.35x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Baycare Hospital Wesley Chapel is $387. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $595. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.35x the Medicare baseline. Located in 4501 Bruce B Downs Blvd, Wesley Chapel, FL.

Cash / Self-Pay

$595

Average discount available for prompt cash payment at this facility.

Insurance Median

$387

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: $595 (669%)

Insurance Median: $387 (435%)

Cash: $595 (669% of Medicare)

Ins. Median: $387 (435% 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 435% of the Medicare baseline (a markup of 335%). 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
Clear Health Alliance	$36	40%
UnitedHealthcare	$36 - $892	40%
Aetna	$37 - $808	42%
Freedom Health	$37	42%
Humana	$37 - $110	42%
Molina Healthcare	$37	42%
Simply Healthcare	$37 - $178	42%
Sunshine Health	$37	42%
Florida Community Care	$39	44%
Cigna	$53 - $862	60%
Baycareplus	$88	99%
Blue Cross Blue Shield	$88 - $524	99%
Solis Health	$97	109%
Wellcare	$124	139%
Molina	$178 - $586	200%
Freedom	$198	223%
Optimum	$198	223%
Ambetter / Centene	$199 - $991	224%
Careplus	$226	254%
Ultimate Health Plan	$297	334%
Avmed	$307 - $486	345%
Evolutions	$496 - $922	558%
First Health	$842	947%
Multiplan	$892	1003%

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 $595.
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 Baycare Hospital Wesley Chapel 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.