CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Fayette County Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $259
Cash Discount Price: $810
vs. Medicare Baseline: 2.91x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Fayette County Hospital is $259. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $810. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.91x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$810

Average discount available for prompt cash payment at this facility.

Insurance Median

$259

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: $810 (911%)

Insurance Median: $259 (291%)

Cash: $810 (911% of Medicare)

Ins. Median: $259 (291% 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 291% of the Medicare baseline (a markup of 191%). 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	$10 - $816	11%
Health Alliance Mcare	$10 - $379	11%
Healthlink Mcr Adv	$10 - $379	11%
Cigna	$12 - $887	13%
Coventry/Ghp-All Plans	$14 - $769	16%
Multiplan - All Plans	$19 - $1,006	21%
Health Alliance - All Other Plans	$21 - $977	24%
Blue Cross Blue Shield	$23 - $994	26%
UnitedHealthcare	$51 - $982	57%
Healthlink Hmo	$52 - $828	58%
Healthlink Ppo - All Other Plans	$52 - $946	58%
Illinicare - All Plans	$89 - $111	100%
Medicaid / KanCare	$89 - $111	100%
Meridian-All Plans	$89 - $111	100%
Humana	$259 - $379	291%

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 $810.
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 Fayette County 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.