CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $218
Cash Discount Price: $493
vs. Medicare Baseline: 2.45x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at UMass Memorial Health - Harrington Hospital is $218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $493. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.45x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$493

Average discount available for prompt cash payment at this facility.

Insurance Median

$218

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: $493 (554%)

Insurance Median: $218 (245%)

Cash: $493 (554% of Medicare)

Ins. Median: $218 (245% 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 245% of the Medicare baseline (a markup of 145%). 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
Workers Compensation [20501]	$31	35%
Aetna	$67 - $493	75%
Wellpoint [11112]	$94	106%
Champva [11001]	$105	118%
Cigna	$106 - $381	119%
Institution [10406]	$106	119%
Mgb Mcr [10124]	$106	119%
Tufts Us Family [11203]	$106	119%
Blue Cross Blue Shield	$109 - $115	123%
Commonwealth Care Alliance [10103]	$111	125%
Fallon Mcr Supp [20202]	$111	125%
Fallon Mcr [10105]	$111	125%
Tufts Mcr [10112]	$111	125%
UnitedHealthcare	$111 - $493	125%
Senior Whole Health [10110]	$113	127%
Fallon Connectorcare [10503]	$172	193%
Tufts Connectorcare [10507]	$180	202%
Medicaid / KanCare	$256	288%
Harvard Pilgrim [10701]	$275 - $330	309%
Hne [11108]	$321	361%
Tufts [11201]	$350	394%
First Health Network [11120]	$370	416%
Evernorth Behavioral Health [27]	$394	443%
Connecticare [11105]	$493	554%
Fallon Carelon Hlth [28]	$493	554%
Fallon Mcaid Carelon Hlth [29]	$493	554%
Grants [20507]	$493	554%
Masshealth Mcd Mbhp [38]	$493	554%
Wellsense Mcaid Carelon Hlth [21]	$493	554%
Hsno/Free Care [10801]	$681	766%

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 $493.
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 Health - Harrington 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.