CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Elkhart General Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $198
  • Cash Discount Price: $202
  • vs. Medicare Baseline: 2.23x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Elkhart General Hospital is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.23x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.
Cash / Self-Pay
$202

Average discount available for prompt cash payment at this facility.

Insurance Median
$198

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: $202 (227%)
Insurance Median: $198 (223%)
Cash: $202 (227% of Medicare)
Ins. Median: $198 (223% 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 223% of the Medicare baseline (a markup of 123%). 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
Mclaren (Mi $49 55%
UnitedHealthcare $49 - $208 55%
Devoted Healthcare $62 - $97 70%
Blue Cross Blue Shield $65 - $275 73%
Caresource $66 - $403 74%
Humana $66 - $217 74%
Mdwise $66 - $403 74%
Mhs $66 - $403 74%
Aetna $92 - $210 103%
Pace $92 103%
Plain Church $138 - $248 155%
Cha $186 - $242 209%
Immergrun $186 - $248 209%
Php $202 - $217 227%
Cigna $223 - $236 251%
Multiplan $223 251%
Signature $226 254%
Encore $229 258%
Heartland $310 349%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 E Blvd, Elkhart, IN 46514
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals