CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Northside Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $395
  • Cash Discount Price: $592
  • vs. Medicare Baseline: 4.44x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Northside Hospital is $395. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $592. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.44x the Medicare baseline. Located in 1000 Johnson Ferry Road, Ne, Atlanta, GA.
Cash / Self-Pay
$592

Average discount available for prompt cash payment at this facility.

Insurance Median
$395

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: $592 (666%)
Insurance Median: $395 (444%)
Cash: $592 (666% of Medicare)
Ins. Median: $395 (444% 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 444% of the Medicare baseline (a markup of 344%). 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
Champus Va $28 31%
Lantern $37 42%
Oscar $49 55%
Ambetter / Centene $55 - $161 62%
Blue Cross Blue Shield $69 - $550 78%
Streamline Imaging $69 78%
Mti $70 79%
One Call Diagnostics $70 79%
Homelink $74 83%
Truths Community $83 93%
Clear Springs Eon Health $87 98%
Medicare (plans) $87 - $106 98%
UnitedHealthcare $87 - $558 98%
Va Ccn $87 98%
Bccp $88 99%
Cbww $88 99%
Humana $88 - $90 99%
Tricare $88 99%
Aetna $89 - $537 100%
Coventry $89 - $537 100%
Caresource $90 - $294 101%
Kaiser $90 - $686 101%
Wellcare $90 101%
Clover Health $91 102%
Pruitt Health Premier $91 102%
Fairly Group $100 112%
Us Dept Of Labor Wc $110 124%
Amerigroup $128 - $143 144%
Cigna $129 - $497 145%
Medicaid / KanCare $143 - $165 161%
Good Samaritan Radiology $158 178%
Med Care Solutions $160 180%
Medlien Healthcare Services $160 180%
Genex/Priority Care Solutions $185 208%
Spreemo $185 208%
Authentic 4D $208 234%
Direct Pay Provider Network Llc $208 234%
Corvel Workers Comp $219 246%
Employers Choice Network $219 246%
Northside Health Network $221 249%
Fieldale Farms Wc $231 260%
Georgia Workers Compensation $231 260%
Georgia Reproductive Specialists $316 355%
Health One Alliance_Ppo $434 488%
Quick Trip $434 488%
Novanet_Ppo $552 621%
Phcs $592 666%
Beech Steet $671 755%
Multiplan $671 755%
Multiplan Workers Comp $671 755%
Careiq $789 887%
Dekalb_Department Of Health $789 887%
Fifa $789 887%
Institutional Marietta Surgery Center $789 887%
Institutional Veterans Evaluation Services $789 887%
Rabun County Boc $789 887%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Johnson Ferry Road, Ne, Atlanta, GA 30342
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals