CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Anderson Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $308
Cash Discount Price: $427
vs. Medicare Baseline: 3.46x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Anderson Hospital is $308. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $427. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.46x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.

Cash / Self-Pay

$427

Average discount available for prompt cash payment at this facility.

Insurance Median

$308

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: $427 (480%)

Insurance Median: $308 (346%)

Cash: $427 (480% of Medicare)

Ins. Median: $308 (346% 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 346% of the Medicare baseline (a markup of 246%). 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
Medicaid / KanCare	$24 - $70	27%
Health Care Service Corporation	$33 - $391	37%
Tricare	$36 - $4,570	40%
Humana	$37 - $4,765	42%
Medicare (plans)	$37 - $4,765	42%
UnitedHealthcare	$37 - $4,765	42%
Aetna	$45 - $4,765	51%
Work Comp	$83 - $26,600	93%
Essence	$93 - $5,008	105%
Devoted Health Ppo	$94 - $4,860	106%
Clear Springs Health	$95 - $4,908	107%
Healthlink	$97	109%
Ambetter / Centene	$135 - $7,049	152%
Blue Choice	$135 - $7,049	152%
Hopetrust	$233 - $12,154	262%
Self Pay	$427 - $25,000	480%
Blue Cross Blue Shield	$458 - $474	515%
Mercy Aco	$555	624%
Mercy Benefit Admin	$555	624%
Cigna	$598	673%
Multiplan/Phcs	$640	720%
Beech Street Corporation	$769	865%

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 $427.
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 Anderson Hospital 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.