CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Northwest Health - Starke

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $197
  • Cash Discount Price: $218
  • vs. Medicare Baseline: 2.22x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Northwest Health - Starke is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $218. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.22x the Medicare baseline. Located in 102 E Culver Rd, Knox, IN.
Cash / Self-Pay
$218

Average discount available for prompt cash payment at this facility.

Insurance Median
$197

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: $218 (245%)
Insurance Median: $197 (222%)
Cash: $218 (245% of Medicare)
Ins. Median: $197 (222% 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 222% of the Medicare baseline (a markup of 122%). 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
One Call $37 42%
Caresource $51 - $66 57%
Blue Cross Blue Shield $66 - $370 74%
Humana $66 - $97 74%
Managed Health Services $66 - $197 74%
Medicaid / KanCare $66 74%
Mhs $66 74%
UnitedHealthcare $66 - $377 74%
Tricare $87 98%
Node Champva $92 103%
Aetna $97 - $460 109%
Medicare (plans) $97 109%
Node Devoted Health Mcr Adv $99 111%
Node Hospice Non Par Agree $99 111%
Node Va $99 111%
In Dept Of Correction $103 116%
Node Pphp Mcr Adv $104 117%
Us Department Of Labor $123 138%
Lutheran $144 162%
Self Pay $144 - $293 162%
Encore $178 - $463 200%
Medpartners $178 200%
Indiana Workers Comp $197 222%
Lutheran Network $197 - $468 222%
Physicians Health Plan $220 247%
Encore Kba Epo $237 267%
Magnacare Ma $237 267%
Alpha Baking $239 269%
Encore Kba Ppo $296 333%
Php $320 360%
Multiplan Inc $426 - $479 479%
Cigna $442 497%
Coventry First Health $460 517%
Sagamore Health Network $468 526%
Community Health Alliance $479 539%
Ppom $500 562%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 E Culver Rd, Knox, IN 46534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals