CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Norton Scott Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $195
Cash Discount Price: $69
vs. Medicare Baseline: 2.19x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Norton Scott Hospital is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.19x the Medicare baseline. Located in 1451 N Gardner St, Scottsburg, IN.

Cash / Self-Pay

$69

Average discount available for prompt cash payment at this facility.

Insurance Median

$195

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: $69 (78%)

Insurance Median: $195 (219%)

Cash: $69 (78% of Medicare)

Ins. Median: $195 (219% 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 219% of the Medicare baseline (a markup of 119%). 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
Caresource Indiana Healthy Indiana Plan (Hip)	$17	19%
Caresource Indiana Hoosier Healthwise (Hhw)	$17	19%
Managed Health Services (Mhs)	$17 - $83	19%
Managed Health Services (Mhs) Hoosier Care Connect	$17	19%
UnitedHealthcare	$17 - $206	19%
Mdwise Hoosier Healthwise (Hhw)	$18	20%
Blue Cross Blue Shield	$76 - $203	85%
Managed Health Services (Mhs) Healthy Indiana Plan (Hip)	$83	93%
Mdwise Healthy Indiana Plan (Hip)	$83	93%
Communicare Advantage	$86	97%
Molina Healthcare	$91 - $93	102%
Caresource Indiana Just4Me	$125	141%
Aetna	$218	245%
Multiplan	$277 - $294	312%
Cigna	$294	331%
Encore Health Network	$294	331%
Prime Health	$294	331%
Ppom	$304	342%
Intercommunity Health Network (Ihn)	$311	350%

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 $69.
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 Scott 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.