CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Nemours Childrens Hospital, Florida

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $240
  • Cash Discount Price: $586
  • vs. Medicare Baseline: 2.70x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Nemours Childrens Hospital, Florida is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $586. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.70x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.
Cash / Self-Pay
$586

Average discount available for prompt cash payment at this facility.

Insurance Median
$240

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: $586 (659%)
Insurance Median: $240 (270%)
Cash: $586 (659% of Medicare)
Ins. Median: $240 (270% 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 270% of the Medicare baseline (a markup of 170%). 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
Truli $74 - $234 83%
Florida Blue $83 - $357 93%
Tricare $88 99%
Aetna $120 - $258 135%
Cigna $161 - $237 181%
Avmed $182 205%
Employers Health Network Fl $234 263%
UnitedHealthcare $257 289%
Evolutions Healthcare $264 297%
Integra Administrative Group $352 396%
Global Medical Management $381 429%
Prime Health Services $381 429%
Star Healthcare Network $381 429%
Velocity $440 495%
First Health Network $457 514%
Pnoa $469 527%
Seminole Tribe Of Fl $469 527%
Private Healthcare Systems $539 606%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6535 Nemours Pkwy, Orlando, FL 32827
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens