CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Medstar Harbor Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $196
Cash Discount Price: $192
vs. Medicare Baseline: 2.20x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Medstar Harbor Hospital is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.20x the Medicare baseline. Located in 3001 South Hanover Street, Baltimore, MD.

Cash / Self-Pay

$192

Average discount available for prompt cash payment at this facility.

Insurance Median

$196

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: $192 (216%)

Insurance Median: $196 (220%)

Cash: $192 (216% of Medicare)

Ins. Median: $196 (220% 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 220% of the Medicare baseline (a markup of 120%). 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
Aetna	$196	220%
Amerigroup	$196	220%
Amerihealth Caritas District Of Columbia	$196	220%
Carefirst Advantage Inc	$196	220%
Carefirst Blue Choice Inc	$196	220%
Cigna	$196	220%
First Health	$196	220%
Hscsn	$196	220%
Humana	$196	220%
Kaiser Permanente	$196	220%
Magellan Behavioral Health Inc	$196	220%
Mamsi	$196	220%
Medstar Family Choice	$196	220%
Medstar Family Choice Inc	$196	220%
Ncppo Healthlink Ppo	$196	220%
Pfc	$196	220%
Private Healthcare Systems (Phcs)	$196	220%
Tricare	$196	220%
United Behavioral Health Inc	$196	220%
UnitedHealthcare	$196	220%

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 $192.
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 Medstar Harbor 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.