CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Madison County Health Care System

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $109
  • Cash Discount Price: $186
  • vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Madison County Health Care System is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $186. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.23x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$186

Average discount available for prompt cash payment at this facility.

Insurance Median
$109

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: $186 (209%)
Insurance Median: $109 (123%)
Cash: $186 (209% of Medicare)
Ins. Median: $109 (123% 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
Aetna $10 - $233 11%
American Hp Mcr Adv-All Plans $10 - $162 11%
Choicecare-All Plans $10 - $341 11%
Medical Associates Hp - All Plans $10 - $154 11%
Medigold-All Plans $10 - $154 11%
Medimore Employee Hp - All Plans $10 - $352 11%
Tricare $10 - $154 11%
UnitedHealthcare $10 - $323 11%
Oscar - All Plans $16 - $232 18%
Blue Cross Blue Shield $21 - $65 24%
Midlands Choice - All Plans $23 - $352 26%
Madison County Sheriff-All Plans $53 - $180 60%
Corvel Wc-All Plans $95 - $323 107%
First Choice-All Plans $101 - $341 114%
First Health-All Plans $101 - $341 114%
Integrated Hp-All Plans $101 - $341 114%
Mutual Of Omaha-All Plans $101 - $341 114%
Plaines Health-All Plans $101 - $341 114%
Preferred Hlth Ntwork-All Plans $101 - $341 114%
Principal Healthcare-All Plans $101 - $341 114%
Usa Managed Care-All Plans $101 - $341 114%
Benefit Admin Of America-All Plans $106 - $359 119%
Iowa Total Care Mcaid-All Plans $106 - $169 119%
Molina Mcaid/Chip -All Plans $109 - $175 123%
Amerigroup Mcaid-All Plans $112 - $179 126%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals