CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Woodlawn Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $110
  • Cash Discount Price: $364
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Woodlawn Hospital is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $364. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.24x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.
Cash / Self-Pay
$364

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

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: $364 (409%)
Insurance Median: $110 (124%)
Cash: $364 (409% of Medicare)
Ins. Median: $110 (124% 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.

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
Blue Cross Blue Shield $17 - $389 19%
Caresource Mcaid Hww $17 19%
Mdwise Excel Hhw & Hcc $17 19%
Mhs Mcaid Hcc $17 19%
Mhs Mcaid Hhw $17 19%
UnitedHealthcare $17 - $369 19%
Aetna $107 - $461 120%
Caresource Mcaid Hip $107 120%
Caresource Mcr Adv $107 120%
Humana $107 - $376 120%
Mdwise Mcaid Excel Hip $107 120%
Mhs Exch Mrktplce-All Other Plans $107 120%
Mhs Mcaid Hip $107 120%
Mhs Mcr Adv $109 123%
Caresource Exch - All Other Plans $139 156%
Ambetter / Centene $142 160%
Partners Direct Health-All Plans $330 371%
Cigna $347 - $412 390%
Parkview Health Plans-All Plans $364 409%
Sagamore All Other Grps - All Other Plans $407 458%
Encore Comm-All Plans $412 463%
Phcs/Multiplan-All Plans $451 507%
Community Health Alliance-All Plans $461 519%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 E 9Th St, Rochester, IN 46975
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals