CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Methodist Hospitals Inc

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $394
Cash Discount Price: $545
vs. Medicare Baseline: 4.43x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Methodist Hospitals Inc is $394. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $545. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.43x the Medicare baseline. Located in 600 Grant St, Gary, IN.

Cash / Self-Pay

$545

Average discount available for prompt cash payment at this facility.

Insurance Median

$394

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: $545 (613%)

Insurance Median: $394 (443%)

Cash: $545 (613% of Medicare)

Ins. Median: $394 (443% 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 443% of the Medicare baseline (a markup of 343%). 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	$66 - $677	74%
Caresource	$66	74%
Humana	$66 - $92	74%
Managed Health Services	$66	74%
Medicaid / KanCare	$66	74%
UnitedHealthcare	$66 - $353	74%
Aetna	$92 - $582	103%
Medicare (plans)	$92	103%
United Heathcare	$92	103%
Zing	$93	105%
Caresource Maketplace	$151	170%
Ambetter / Centene	$183	206%
Cigna	$296 - $328	333%
Magnacare	$435	489%
Physicians Health Plan Of Northern Indiana	$445 - $455	501%
Encore	$462 - $700	520%
Phcs	$524 - $535	589%
Siho	$539 - $551	606%
Sagamore	$554 - $567	623%
Multiplan	$562 - $575	632%
Hfn	$601 - $669	676%

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 $545.
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 Methodist Hospitals Inc 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.