CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mercyone Clinton Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $93
  • Cash Discount Price: $501
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mercyone Clinton Medical Center is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $501. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.05x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$501

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $501 (563%)
Insurance Median: $93 (105%)
Cash: $501 (563% of Medicare)
Ins. Median: $93 (105% 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.

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
Iowa Dept Of Public Health $9 - $488 10%
Iowa Total Care $80 90%
Medicaid / KanCare $81 91%
Bcn Domestic $89 100%
Blue Benefit Administrators Of Massachusetts $89 100%
Blue Care Network $89 100%
Blue Cross Blue Shield $89 - $92 100%
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%
Kaiser Domestic $89 100%
Pre-Employment $89 100%
Wc Domestic $89 100%
Aetna $91 - $427 102%
Medicare (plans) $91 - $94 102%
UnitedHealthcare $93 - $488 105%
Amish Hospital Aid $123 138%
Oscar $126 142%
Health Choices $138 155%
Medical Associates $138 155%
Preferred Health Choice $141 159%
Ambetter / Centene $156 175%
Claimdoc $186 209%
Nova $186 209%
Geha $195 219%
The Alliance $296 333%
1199 National Benefit Fund $427 480%
Allied Benefit Systems $427 480%
Asr Health Benefits $427 480%
Christian Brother Services $427 480%
Coventry $427 480%
First Health $427 480%
Lucent Health $427 480%
Luminare Health $427 480%
Medical Mutual $427 480%
Meritain $427 480%
Trustmark Small Business Benefits $427 480%
Webtpa $427 480%
Health Partners $428 481%
Auxiant $439 494%
Cigna $439 494%
Medica $439 494%
Midlands $439 494%
Midlands Choice $439 494%
Multiplan $439 494%
Qualcare $439 494%
Usa Managed Care $464 522%
Crime Victim Assistance $488 549%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals