CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Franciscan Health Lafayette

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $446
Cash Discount Price: $204
vs. Medicare Baseline: 5.02x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Franciscan Health Lafayette is $446. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $204. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.02x the Medicare baseline. Located in 1701 S Creasy Ln, Lafayette, IN.

Cash / Self-Pay

$204

Average discount available for prompt cash payment at this facility.

Insurance Median

$446

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: $204 (229%)

Insurance Median: $446 (502%)

Cash: $204 (229% of Medicare)

Ins. Median: $446 (502% 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 502% of the Medicare baseline (a markup of 402%). 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
Mdwise [1175]	$66	74%
Medicaid / KanCare	$66 - $80	74%
Managed Health Services [1302]	$68	76%
Blue Cross Blue Shield	$75 - $341	84%
Unicare [1150]	$75 - $341	84%
Medicare (plans)	$90 - $92	101%
Workers Comp [1172]	$180 - $184	202%
Aetna	$186 - $653	209%
Managed Care [2000]	$186 - $831	209%
Commercial [2001]	$391 - $923	440%
UnitedHealthcare	$402 - $491	452%
United Medical Resources [1158]	$446	502%
United Medical Resources [1301]	$446 - $491	502%
Humana	$599	674%
Cigna	$634 - $738	713%
Great West Insurance [1055]	$634	713%

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 $204.
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 Franciscan Health Lafayette 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.