CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Warner Hospital and Health Services

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $462
Cash Discount Price: $578
vs. Medicare Baseline: 5.20x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Warner Hospital and Health Services is $462. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $578. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.20x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$578

Average discount available for prompt cash payment at this facility.

Insurance Median

$462

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: $578 (650%)

Insurance Median: $462 (520%)

Cash: $578 (650% of Medicare)

Ins. Median: $462 (520% 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 520% of the Medicare baseline (a markup of 420%). 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
Aetna	$213 - $520	240%
Blue Cross Blue Shield	$213 - $600	240%
Harmony Hp Mcaid-All Plans	$213	240%
Medicaid / KanCare	$213	240%
Meridian Hp-All Plans	$213	240%
Molina-All Other Plans	$213	240%
Health Alliance Med Adv	$223 - $251	251%
Humana	$223 - $520	251%
Molina Mcr/Mcd Dual	$223 - $251	251%
UnitedHealthcare	$223 - $520	251%
Wellcare Mcr Adv-All Plans	$223 - $251	251%
Healthlink Hmo	$424 - $478	477%
City Of Clinton (Employees Serv)-All Plans	$435 - $490	489%
Cigna	$451 - $508	507%
Caterpillar-All Plans	$462 - $520	520%
Multiplan Phcs-All Plans	$462 - $520	520%
Health Alliance-All Other Plans	$479 - $539	539%
Healthlink Ppo/Work Comp-All Other Plans	$479 - $539	539%
Consociate Care Ppo-All Plans	$490 - $551	551%
Hfn Ppo/Epo-All Plans	$490 - $551	551%
Three Rivers-All Plans	$517 - $582	581%

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 $578.
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 Warner Hospital and Health Services 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.