CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Piedmont Athens Regional Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $106
Cash Discount Price: $286
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Piedmont Athens Regional Medical Center is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $286. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.19x the Medicare baseline. Located in 1199 Prince Avenue, Athens, GA.

Cash / Self-Pay

$286

Average discount available for prompt cash payment at this facility.

Insurance Median

$106

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: $286 (322%)

Insurance Median: $106 (119%)

Cash: $286 (322% of Medicare)

Ins. Median: $106 (119% 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.

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
Cigna	$45 - $64	51%
Blue Cross Blue Shield	$53 - $94	60%
Alliant Health Plans Of Georgia [10952]	$64	72%
Medicaid / KanCare	$101 - $106	114%
Aetna	$105	118%
UnitedHealthcare	$216	243%
Kaiser [10500]	$524	589%
First Health [10303]	$667	750%
Novanet [10819]	$714	803%
Beechstreet [10800]	$781	878%
Multiplan [10600]	$781	878%
Phcs [10601]	$781	878%

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 $286.
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 Piedmont Athens Regional Medical Center 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.