CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Pulaski Memorial Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $36
Cash Discount Price: $140
vs. Medicare Baseline: 0.40x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Pulaski Memorial Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.40x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$140

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $140 (157%)

Insurance Median: $36 (40%)

Cash: $140 (157% of Medicare)

Ins. Median: $36 (40% 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.

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
UnitedHealthcare	$9 - $290	10%
Ambetter / Centene	$10 - $114	11%
Blue Cross Blue Shield	$10 - $244	11%
Caresource Mcaid Hip	$10 - $114	11%
Caresource Mcare Hmo	$10 - $114	11%
Cenpatico Mcaid Hip	$10 - $114	11%
Humana	$10 - $296	11%
Mdwise Mcaid Hcc	$10 - $17	11%
Mdwise Mcaid Hhw	$10 - $17	11%
Mdwise Mcaid Hip - All Other Plans	$10 - $114	11%
Mhs Mcaid Hip	$10 - $114	11%
Mhs Mcare Allwell	$10 - $115	11%
Multiplan - All Plans	$10 - $331	11%
Caresource Exch Hmo Hix - All Other Plans	$12 - $142	13%
Encore Ppo - All Other Plans	$15 - $312	17%
Caresource Mcaid Hhw	$17 - $36	19%
Cenpatico Mcaid Hhw - All Other Plans	$17 - $36	19%
Cigna	$17 - $349	19%
Mhs Mcaid Hhw/Hcc	$17 - $36	19%
Sagamore - All Other Plans	$17 - $278	19%
Sagamore Rose Acre	$17 - $274	19%
Community Health Alliance - All Plans	$20 - $327	22%
Encore Workers Comp	$28 - $331	31%
Aetna	$132	148%

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 $140.
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 Pulaski Memorial Hospital 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.