CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Boston Children's Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $384
Cash Discount Price: $541
vs. Medicare Baseline: 4.32x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Boston Children's Hospital is $384. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $541. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.32x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$541

Average discount available for prompt cash payment at this facility.

Insurance Median

$384

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: $541 (608%)

Insurance Median: $384 (432%)

Cash: $541 (608% of Medicare)

Ins. Median: $384 (432% 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 432% of the Medicare baseline (a markup of 332%). 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
Blue Cross Blue Shield	$128 - $357	144%
Unicare	$141	159%
Cdphp	$265 - $460	298%
Harvard Pilgrim	$275 - $366	309%
United	$324 - $452	364%
Aetna	$325 - $454	366%
Mgb/Allways	$329 - $400	370%
Tufts Public Plan	$332 - $333	373%
United Ri Nj Ny	$341	384%
Ambetter / Centene	$342	385%
Carelon Strategies/Bhs	$352	396%
UnitedHealthcare	$352 - $460	396%
Carelon/Beacon	$406	457%
Fallon	$413 - $417	465%
Health New England	$437	492%
Cigna	$460 - $488	517%
Ets/Lifetrac	$460	517%
Interlink Transplant	$460	517%
Community Health Options	$487	548%
Humana	$487	548%
Coventry/Hcvm/First Health	$498	560%
Multiplan/Phcs	$498 - $514	560%

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 $541.
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 Boston Children's 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.