CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Memorial Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $499
Cash Discount Price: $831
vs. Medicare Baseline: 5.61x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Memorial Medical Center is $499. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $831. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.61x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$831

Average discount available for prompt cash payment at this facility.

Insurance Median

$499

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: $831 (935%)

Insurance Median: $499 (561%)

Cash: $831 (935% of Medicare)

Ins. Median: $499 (561% 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 561% of the Medicare baseline (a markup of 461%). 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
Blue Cross Blue Shield	$37 - $831	42%
Healthlink	$56 - $524	63%
Veterans Administration	$66	74%
Medicaid / KanCare	$70	79%
Molina	$72	81%
Aetna	$92 - $632	103%
Health Alliance	$92 - $540	103%
Medicare (plans)	$92 - $831	103%
Tricare	$92	103%
UnitedHealthcare	$92 - $515	103%
Humana	$96 - $499	108%
Commercial Workers Compensation	$202	227%
Illinois Workers Compensation	$212	238%
Current Health Network Ppo	$374	421%
Cigna	$436	490%
Phcs/Multiplan	$449 - $499	505%
6 Degrees Health	$499	561%
Hopetrust	$499	561%
Hst	$499	561%
Magellan	$499	561%
Consociate	$540	607%
Hfn	$540	607%
Preferred Plan	$623	701%
Soi Mcfarland	$623	701%
Soi Rushville	$623	701%
Corvel	$665	748%
Methodist First Choice	$665	748%
Mutual Medical Plans	$706	794%
Liability	$831	935%

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 $831.
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 Memorial 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.