CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Spencer Municipal Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $407
  • Cash Discount Price: $359
  • vs. Medicare Baseline: 4.58x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Spencer Municipal Hospital is $407. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $359. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.58x the Medicare baseline. Located in 1200 1St Avenue East, Spencer, IA.
Cash / Self-Pay
$359

Average discount available for prompt cash payment at this facility.

Insurance Median
$407

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: $359 (404%)
Insurance Median: $407 (458%)
Cash: $359 (404% of Medicare)
Ins. Median: $407 (458% 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 458% of the Medicare baseline (a markup of 358%). 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
Wellmark Hmo $73 82%
Humana $76 - $455 85%
Medicare (plans) $76 85%
UnitedHealthcare $76 - $431 85%
Wellmark Ppo $80 90%
Medicaid / KanCare $85 96%
Healthpartners (All) $383 431%
Midlands Choice - Ilcc $407 458%
Midlands Choice - Morton Bldg $407 458%
Coventry - Commercial Hmo $431 485%
Avera Health Plan $455 512%
Coventry - Commercial Ppo $455 512%
First Choice Of Midwest $455 512%
Midlands Choice (All Others) $455 512%
Sanford Health $455 512%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 1St Avenue East, Spencer, IA 51301
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals