CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Boone County Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $47
Cash Discount Price: $42
vs. Medicare Baseline: 0.53x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Boone County Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.53x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $42 (47%)

Insurance Median: $47 (53%)

Cash: $42 (47% of Medicare)

Ins. Median: $47 (53% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Choice Care Mcr Adv - All Plans	$21 - $145	24%
Humana	$21 - $145	24%
Iowa Hlth Adv - All Plans	$21	24%
Mt Carmel Hp - All Plans	$21 - $145	24%
UnitedHealthcare	$21 - $31	24%
Va Ccn-All Plans	$21 - $145	24%
Aetna	$22 - $275	25%
Amerigroup Mcr Adv - All Other Plans	$22 - $146	25%
Meridian Mcaid - All Plans	$23 - $159	26%
Iowa Total Care Mcaid - All Plans	$24 - $162	27%
Medicaid / KanCare	$24	27%
Healthsmart Accell Network	$36 - $247	40%
Medical Associates Hp-All Plans	$39	44%
Healthsmart Ppo - All Other Plans	$42	47%
Health Alliance-All Plans	$47 - $317	53%
Midlands Choice-All Plans	$48	54%
Mutually Preferred-All Plans	$49	55%
Wellmark Hmo	$58	65%
Wellmark Ppo - All Other Plans	$64	72%
Tricare	$89	100%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $42.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72040.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Boone County Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72040.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.