CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Hamilton Memorial Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $217
  • Cash Discount Price: $240
  • vs. Medicare Baseline: 2.44x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Hamilton Memorial Hospital is $217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $240. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.44x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.
Cash / Self-Pay
$240

Average discount available for prompt cash payment at this facility.

Insurance Median
$217

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: $240 (270%)
Insurance Median: $217 (244%)
Cash: $240 (270% of Medicare)
Ins. Median: $217 (244% 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 244% of the Medicare baseline (a markup of 144%). 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
Aetna $37 - $254 42%
Blue Cross Blue Shield $37 - $257 42%
Health Alliance $37 - $226 42%
Medicare (plans) $37 - $113 42%
UnitedHealthcare $37 - $202 42%
Wellcare $37 - $113 42%
Medicaid / KanCare $105 - $113 118%
Humana $113 127%
Alliance Coal $198 223%
Healthscope $198 223%
Wellfirst (Ssmhic) $198 223%
Hope Trust $212 238%
Cigna $222 250%
Hfn, Inc $226 - $254 254%
Healthlink $240 - $254 270%
Multiplan $240 270%
Siho $254 286%
Three Rivers Provider $254 286%
Healthsmart $268 301%
Stratose $268 301%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 S Marshall Avenue, McLeansboro, IL 62859
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals