CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $115
Cash Discount Price: $441
vs. Medicare Baseline: 1.29x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at UMass Memorial Healthalliance Hospitals is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.29x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$441

Average discount available for prompt cash payment at this facility.

Insurance Median

$115

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: $441 (496%)

Insurance Median: $115 (129%)

Cash: $441 (496% of Medicare)

Ins. Median: $115 (129% 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
Workers Compensation [20501]	$31	35%
Champva [11001]	$94	106%
Wellpoint [11112]	$94	106%
Cigna	$106 - $278	119%
Correctional Care [11003]	$106	119%
Institution [10406]	$106 - $234	119%
Medicaid / KanCare	$106 - $229	119%
Medicare (plans)	$106	119%
Tufts Dual [10111]	$106	119%
Tufts Us Family [11203]	$106	119%
Blue Cross Blue Shield	$109 - $115	123%
Aetna	$111 - $288	125%
Commonwealth Care Mcr [10115]	$111	125%
Fallon Mcr Supp [20202]	$111	125%
Harvard Pilgrim Mcr [10106]	$111	125%
Mgb Mcr [10124]	$111	125%
Tufts Mcr [10112]	$111	125%
UnitedHealthcare	$111 - $441	125%
Senior Whole Health [10110]	$113	127%
Harvard Pilgrim [10701]	$130 - $156	146%
Fallon Connectorcare [10503]	$172	193%
Tufts Connectorcare [10507]	$180	202%
Tufts [11201]	$221	249%
Hne [11108]	$246	277%
Hsno/Free Care [10801]	$294	331%
First Health Network [11120]	$331	372%
Multiplan [11109]	$331	372%
Connecticare [11105]	$441	496%
Fallon Carelon Hlth [28]	$441	496%
Fallon Mcaid Carelon Hlth [29]	$441	496%
Grants [20507]	$441	496%

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 $441.
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 UMass Memorial Healthalliance Hospitals 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.