CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Houlton Regional Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $138
Cash Discount Price: $332
vs. Medicare Baseline: 1.55x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Houlton Regional Hospital is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $332. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.55x the Medicare baseline. Located in 20 Hartford Street, Houlton, ME.

Cash / Self-Pay

$332

Average discount available for prompt cash payment at this facility.

Insurance Median

$138

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: $332 (373%)

Insurance Median: $138 (155%)

Cash: $332 (373% of Medicare)

Ins. Median: $138 (155% 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
Blue Cross Blue Shield	$11 - $275	12%
Aetna	$12 - $280	13%
Tricare	$31 - $260	35%
Martins_Point	$38 - $318	43%
Wellcare	$42 - $277	47%
Community_Health	$66 - $549	74%
Cigna	$68 - $568	76%
United	$71 - $593	80%

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 $332.
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 Houlton Regional 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.