CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Kootenai Health

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $38
Cash Discount Price: $192
vs. Medicare Baseline: 0.43x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Kootenai Health is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.43x the Medicare baseline. Located in 2003 Kootenai Health Way, Coeur D'Alene, ID.

Cash / Self-Pay

$192

Average discount available for prompt cash payment at this facility.

Insurance Median

$38

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: $192 (216%)

Insurance Median: $38 (43%)

Cash: $192 (216% of Medicare)

Ins. Median: $38 (43% 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
Coordinated Care Of Washington	$7 - $22	8%
Molina Healthcare Of Idaho	$7 - $95	8%
Molina Healthcare Of Washington	$7 - $22	8%
Aetna	$10 - $212	11%
Blue Cross Blue Shield	$10 - $332	11%
Humana	$10 - $90	11%
Magellan	$10 - $31	11%
Pacificsource	$10 - $210	11%
Premera	$10 - $158	11%
Regence Blue Shield Of Idaho	$10 - $90	11%
UnitedHealthcare	$10 - $230	11%
Wellpoint	$10 - $31	11%
Group Health/Kaiser	$15 - $324	17%
Mountain Health Co-Op	$198	223%
Cigna	$210 - $213	236%
First Choice Health (Ameriben)	$218 - $222	245%
Interwest Health	$218	245%

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 $192.
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 Kootenai Health 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.