CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Atrium Health Navicent the Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $49
Cash Discount Price: $238
vs. Medicare Baseline: 0.55x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Atrium Health Navicent the Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $238. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.55x the Medicare baseline. Located in 777 Hemlock Street, Macon, GA.

Cash / Self-Pay

$238

Average discount available for prompt cash payment at this facility.

Insurance Median

$49

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: $238 (268%)

Insurance Median: $49 (55%)

Cash: $238 (268% of Medicare)

Ins. Median: $49 (55% 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
Aetna	$10 - $328	11%
Blue Cross Blue Shield	$10 - $86	11%
Care Source	$10 - $88	11%
Clover	$10 - $88	11%
Eon Health	$10 - $88	11%
Georgia Health Advantage	$10 - $86	11%
Humana	$10 - $326	11%
UnitedHealthcare	$10 - $712	11%
Pruitt Health	$11 - $86	12%
Alliant	$12 - $103	13%
Ambetter / Centene	$14 - $242	16%
Cigna	$23 - $88	26%
Securehealth	$26 - $166	29%
Kaiser	$31 - $309	35%
Multiplan	$309 - $380	348%
Ibg	$336	378%
Novanet	$380	427%
Three Rivers Provider Network	$404	454%
Beechstreet	$442	497%

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 $238.
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 Atrium Health Navicent the 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.