CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Portneuf Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $460
  • Cash Discount Price: $326
  • vs. Medicare Baseline: 5.17x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Portneuf Medical Center is $460. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $326. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.17x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.
Cash / Self-Pay
$326

Average discount available for prompt cash payment at this facility.

Insurance Median
$460

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: $326 (367%)
Insurance Median: $460 (517%)
Cash: $326 (367% of Medicare)
Ins. Median: $460 (517% 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 517% of the Medicare baseline (a markup of 417%). 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
Aetna $112 - $460 126%
Healthscope Benefits [2290] $112 126%
UnitedHealthcare $112 - $489 126%
Black Lung [6055] $223 251%
Employee Benefit Management Services [2445] $223 - $326 251%
Healthcare Highways [2210] $223 - $516 251%
Lucent Health [6000] $223 251%
Moda Health [6100] $223 251%
Oncology Patient Assistance Programs [2295] $223 251%
Pending Ssi [1616] $223 251%
Web Tpa [2115] $223 251%
Pacific Source Health Plans [2850] $312 351%
Liberty Health Share Lhs/Medcost Solutions Llc [2400] $326 367%
Medishare Christian Care [1645] $326 367%
Multiplan [1680] $364 - $516 409%
Cigna $400 450%
First Health [1375] $448 504%
Mailhandlers [1595] $460 517%
Selecthealth [3740] $460 - $489 517%
Geha [1415] $489 550%
Humana $489 550%
Administrative Concepts [1005] $516 580%
Healthfirst [2395] $516 580%
Healthnet [1495] $516 580%
Hometown Health [2155] $516 580%
Mayo Clinic Health Solutions [2280] $516 580%
Meritain Health [1655] $516 580%
Mutual Of Omaha [1685] $516 580%
National Association Of Letter Carriers [1695] $516 580%
New Era Life Insurance Company [1705] $516 580%
Pan American Life Insurance Co [1770] $516 580%
Pba [1775] $516 580%
Phcs [1780] $516 580%
Planned Administrators Inc [2360] $516 580%
Trustmark [2030] $516 580%
Ut Id Teamsters [3760] $516 580%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hospital Way, Pocatello, ID 83201
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals