CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Norton-King's Daughters' Health

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $353
Cash Discount Price: $99
vs. Medicare Baseline: 3.97x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Norton-King's Daughters' Health is $353. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.97x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.

Cash / Self-Pay

$99

Average discount available for prompt cash payment at this facility.

Insurance Median

$353

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: $99 (111%)

Insurance Median: $353 (397%)

Cash: $99 (111% of Medicare)

Ins. Median: $353 (397% 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 397% of the Medicare baseline (a markup of 297%). 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	$9 - $396	10%
Blue Cross Blue Shield	$17 - $332	19%
Managed Health Services Of Indiana	$17	19%
UnitedHealthcare	$17 - $353	19%
Humana	$92	103%
Managed Health Services	$95 - $143	107%
Caresource Of Kentucky	$129	145%
Caresource Of Indiana	$138	155%
Custom Design Benefits	$184 - $225	207%
Cigna	$382	430%
Encore	$382	430%
Quality Care Partners	$400	450%
Bluegrass	$405	456%
First Health	$405	456%
Healthlink	$405	456%
Vha/Tristate	$405	456%
Multiplan/Phcs	$414	466%
Indiana Health Network	$428	481%
Siho	$428	481%

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 $99.
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 Norton-King's Daughters' Health 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.