CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mercyone Newton Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $195
  • Cash Discount Price: $252
  • vs. Medicare Baseline: 2.19x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mercyone Newton Medical Center is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $252. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.19x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$252

Average discount available for prompt cash payment at this facility.

Insurance Median
$195

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: $252 (283%)
Insurance Median: $195 (219%)
Cash: $252 (283% of Medicare)
Ins. Median: $195 (219% 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 219% of the Medicare baseline (a markup of 119%). 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
Aetna $82 - $363 92%
Medicare (plans) $82 - $86 92%
Blue Cross Blue Shield $83 - $89 93%
UnitedHealthcare $84 - $221 94%
Blue Benefit Administrators Of Massachusetts $89 100%
Blue Care Network $89 100%
Blue Distinction Transplant $89 100%
Blue Shield - Ca $89 100%
Blue Shield - Id (Regence) $89 100%
Blue Shield - Ny Highmark Northeastern $89 100%
Blue Shield - Ny Highmark Western $89 100%
Blue Shield - Pa (Highmark) $89 100%
Blue Shield - Wa (Regence) $89 100%
Iowa Total Care $100 112%
Medicaid / KanCare $101 - $102 114%
Amish Hospital Aid $112 126%
Oscar $119 134%
Centivo $121 136%
Ambetter / Centene $141 159%
Claimdoc $169 190%
Nova $169 190%
Geha $221 249%
Newton Correctional Facility $252 283%
Health Choices $292 328%
Medical Associates $292 328%
Health Partners $341 384%
Auxiant $356 400%
Cigna $356 400%
Health Alliance $356 400%
Medica $356 400%
Midlands $356 400%
Midlands Choice $356 400%
1199 National Benefit Fund $363 408%
Allied Benefit Systems $363 408%
Asr Health Benefits $363 408%
Christian Brother Services $363 408%
Coventry $363 408%
First Health $363 408%
Lucent Health $363 408%
Luminare Health $363 408%
Medical Mutual $363 408%
Meritain $363 408%
Trustmark Small Business Benefits $363 408%
Webtpa $363 408%
Crime Victim Assistance $387 435%
Iowa Dept Of Public Health $387 435%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals