CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $56
Cash Discount Price: $119
vs. Medicare Baseline: 0.63x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Ascension Providence Hospital, Southfield and Novi is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $119. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.63x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

$119

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

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: $119 (134%)

Insurance Median: $56 (63%)

Cash: $119 (134% of Medicare)

Ins. Median: $56 (63% 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
Priority Ppo	$22	25%
Hap Alliance Health	$26	29%
Hap Hmo Pos	$26	29%
Priority Health Hmo	$26	29%
Hap Preferred	$31	35%
Bc Metro Detroit Epo	$33 - $56	37%
Bc Metro Detroit Hmo	$37 - $56	42%
Bcn Local Network Southeast	$37 - $56	42%
Blue Caid Michigan	$50	56%
Harbor Health Mcd	$50	56%
Medicaid / KanCare	$50 - $86	56%
Molina Health	$50 - $53	56%
Total Health Care	$50	56%
UnitedHealthcare	$50	56%
Blue Care Network	$55 - $56	62%
Blue Cross Blue Shield	$55 - $56	62%
Amerihealth Vip Care Mcr	$74 - $85	83%
Aetna	$79 - $86	89%
Auto Insurance	$86	97%
Jvhl - Mcr Replacement	$86	97%
Mcr Replacement	$86	97%
Veterans Choice	$86	97%
Humana	$87	98%
Meridian Wellcare	$91	102%
Molina Advantage	$91	102%
Ambetter / Centene	$108	121%
Molina Marketplace	$108	121%
Smart Health	$119	134%

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 $119.
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 Ascension Providence Hospital, Southfield and Novi 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.