CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Clarinda Regional Health Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $163
  • Cash Discount Price: $183
  • vs. Medicare Baseline: 1.83x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Clarinda Regional Health Center is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $183. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.83x the Medicare baseline. Located in 220 Essie Davison Drive, Clarinda, IA.
Cash / Self-Pay
$183

Average discount available for prompt cash payment at this facility.

Insurance Median
$163

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: $183 (206%)
Insurance Median: $163 (183%)
Cash: $183 (206% of Medicare)
Ins. Median: $163 (183% 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
Ambetter / Centene $149 - $162 168%
Molina Mcr Adv-All Plans $149 168%
UnitedHealthcare $149 - $295 168%
Blue Cross Blue Shield $152 - $249 171%
Ia Total Care Mcaid-All Plans $163 183%
Amerigroup Ia Mcaid-All Plans $165 186%
Geha-All Plans $289 325%
Coventry Health-All Other Plans $292 328%
Midlands Choice-All Plans $295 332%
Multiplan-All Plans $295 332%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 220 Essie Davison Drive, Clarinda, IA 51632
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals