CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Wabash General Hospital 1

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $295
Cash Discount Price: $382
vs. Medicare Baseline: 3.32x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Wabash General Hospital 1 is $295. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $382. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.32x the Medicare baseline. Located in 1418 College Drive, Mount Carmel, IL.

Cash / Self-Pay

$382

Average discount available for prompt cash payment at this facility.

Insurance Median

$295

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: $382 (430%)

Insurance Median: $295 (332%)

Cash: $382 (430% of Medicare)

Ins. Median: $295 (332% 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 332% of the Medicare baseline (a markup of 232%). 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	$109 - $342	123%
UnitedHealthcare	$115 - $314	129%
Health Alliance Mcr Adv - All Plans	$117 - $124	132%
Aetna	$136 - $334	153%
Meridian Mcaid - All Plans	$136	153%
Molina Mcaid - All Plans	$136	153%
Healthlink Hmo	$259 - $275	291%
Cigna	$278 - $295	313%
Encore Combined Ip/Op Only	$278 - $295	313%
Hope Trust - All Plans	$278 - $295	313%
Healthlink Ppo - All Other Plans	$296 - $314	333%
Phcs - All Plans	$296 - $314	333%
Health Smart - All Plans	$315 - $334	354%
Hfn - All Plans	$315 - $334	354%
Multiplan - All Plans	$315 - $334	354%
Siho Network - All Plans	$315 - $334	354%
Encore Health Network Ip/Op Only - All Other Plans	$333 - $354	375%

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 $382.
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 Wabash General Hospital 1 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.