CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Memorial Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $405
Cash Discount Price: $360
vs. Medicare Baseline: 4.56x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Memorial Hospital is $405. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $360. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.56x the Medicare baseline. Located in 1454 N County Road 2050 E, Carthage, IL.

Cash / Self-Pay

$360

Average discount available for prompt cash payment at this facility.

Insurance Median

$405

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: $360 (405%)

Insurance Median: $405 (456%)

Cash: $360 (405% of Medicare)

Ins. Median: $405 (456% 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 456% of the Medicare baseline (a markup of 356%). 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
Humana	$75 - $450	84%
Aetna	$126 - $450	142%
Blue Cross Blue Shield	$126 - $450	142%
Cigna	$126 - $450	142%
Health Alliance	$126 - $450	142%
Meridian	$126 - $450	142%
Molina	$126 - $450	142%
UnitedHealthcare	$126 - $450	142%
Consociate	$382 - $450	430%
Healthlink	$382 - $450	430%
Private Healthcare Systems	$382	430%
Integrated Health Plan	$396	445%
First Health Network	$400 - $450	450%
Health Dynamics	$405	456%
Health Payors Org	$405	456%
Iowa Health Solutions	$405	456%
Multiplan	$405	456%
Preferred Plan Inc	$405	456%
Three Rivers Provider Network	$405	456%
Health First Network	$410	461%
Pponext	$410	461%
Corvel	$428	481%

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 $360.
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 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.