CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Caribou Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $353
Cash Discount Price: $261
vs. Medicare Baseline: 3.97x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Caribou Medical Center is $353. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $261. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.97x the Medicare baseline. Located in 300 South 3Rd West, Soda Springs, ID.

Cash / Self-Pay

$261

Average discount available for prompt cash payment at this facility.

Insurance Median

$353

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: $261 (294%)

Insurance Median: $353 (397%)

Cash: $261 (294% of Medicare)

Ins. Median: $353 (397% 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 397% of the Medicare baseline (a markup of 297%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
First Choice Health-All Plans	$139	156%
Humana	$164 - $172	184%
Pacific Source Mcr Adv	$164 - $172	184%
Regence Blue Shield Mcr	$164 - $172	184%
Select Health Mcr Adv	$164 - $172	184%
Select Health/Bright Path Mcr Adv	$164 - $172	184%
Blue Cross Blue Shield	$165 - $375	186%
Aetna	$229 - $375	258%
Bc Qualified Hp (Qhp)	$338 - $356	380%
Deseret Healthcare-All Plans	$345 - $364	388%
Pacific Source-All Other Plans	$353 - $372	397%
UnitedHealthcare	$353 - $372	397%
Cigna	$356 - $375	400%
Montana Health Co-Op-All Plans	$356 - $375	400%
Regence Blue Shield-All Other Plans	$356 - $375	400%
Select Health-All Other Plans	$356 - $375	400%

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 $261.
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 Caribou Medical Center 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.