CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Insight Hospital and Medical Center Coldwater

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $265
  • Cash Discount Price: $302
  • vs. Medicare Baseline: 2.98x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Insight Hospital and Medical Center Coldwater is $265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $302. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.98x the Medicare baseline. Located in 274 E Chicago St, Coldwater, MI.
Cash / Self-Pay
$302

Average discount available for prompt cash payment at this facility.

Insurance Median
$265

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: $302 (340%)
Insurance Median: $265 (298%)
Cash: $302 (340% of Medicare)
Ins. Median: $265 (298% 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 298% of the Medicare baseline (a markup of 198%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $265 298%
Blue Cross Blue Shield $265 298%
Cofinity $265 298%
Frontpath $265 298%
Hap $265 298%
Health Alliance Plan $265 298%
Humana $265 298%
Mclaren $265 298%
Medicaid / KanCare $265 298%
Medicare (plans) $265 298%
Multi-Plan $265 298%
Paramount Elite $265 298%
Paramount Hmo $265 298%
Paramount Ppo $265 298%
Phcs $265 298%
Php Northern Indiana $265 298%
Php Of Mid Michigan $265 298%
Priority $265 298%
UnitedHealthcare $265 298%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 274 E Chicago St, Coldwater, MI 49036
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals