CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Lost Rivers Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $284
  • Cash Discount Price: $352
  • vs. Medicare Baseline: 3.19x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Lost Rivers Medical Center is $284. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $352. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.19x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.
Cash / Self-Pay
$352

Average discount available for prompt cash payment at this facility.

Insurance Median
$284

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: $352 (396%)
Insurance Median: $284 (319%)
Cash: $352 (396% of Medicare)
Ins. Median: $284 (319% 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 319% of the Medicare baseline (a markup of 219%). 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
Provider Network Of America-All Plans $160 180%
Select Health Brightpath-All Other Plans $249 280%
Tricare $249 280%
Ihcn Brightpath-All Other Plans $263 296%
Va Pccc-All Plans $269 303%
Blue Cross Blue Shield $277 - $440 312%
Humana $277 - $440 312%
Ihcn Brightpath Mcr Adv $277 312%
Molina Mcr Adv-All Plans $277 312%
Pacificsource Mcr Adv $277 312%
Regence/Brightpth Slhp Mcr $277 312%
Select Health Mcr Adv $277 312%
Prime Hlth Mcr Adv $291 327%
Aetna $299 - $414 336%
Cigna $409 460%
First Choice-All Plans $409 460%
Pacificsource Navigator-All Other Plans $418 470%
UnitedHealthcare $418 470%
Altius Health Plan-All Plans $427 480%
Regence Blue Shield-All Other Plans $1,619 1821%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 551 Highland Drive, Arco, ID 83213
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals