CMS Price Transparency Data
X-ray, neck (cervical spine)
Facility: Trinity Health Muskegon Hospital
Billing Code: 72040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72040
- Insurance Median: $216
- Cash Discount Price: $187
- vs. Medicare Baseline: 2.43x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Trinity Health Muskegon Hospital is $216. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.43x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$187
Average discount available for prompt cash payment at this facility.
Insurance Median
$216
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: $187 (210%)
Insurance Median: $216 (243%)
Cash: $187 (210% of Medicare)
Ins. Median: $216 (243% 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 243% of the Medicare baseline (a markup of 143%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 | $49 - $91 | 55% |
| Medicaid / KanCare | $49 - $50 | 55% |
| Access Health | $65 | 73% |
| Bcn Domestic | $79 | 89% |
| Blue Benefit Administrators Of Massachusetts | $79 | 89% |
| Blue Care Network | $79 | 89% |
| Blue Distinction Transplant | $79 | 89% |
| Blue Shield - Ca | $79 | 89% |
| Blue Shield - Id (Regence) | $79 | 89% |
| Blue Shield - Ny Highmark Northeastern | $79 | 89% |
| Blue Shield - Ny Highmark Western | $79 | 89% |
| Blue Shield - Pa (Highmark) | $79 | 89% |
| Blue Shield - Wa (Regence) | $79 | 89% |
| Health Choices | $79 - $227 | 89% |
| Kaiser Domestic | $79 | 89% |
| U Of M Health Plan | $87 - $227 | 98% |
| Aetna | $91 - $121 | 102% |
| Blue Care Network Advantage | $91 | 102% |
| Medicare (plans) | $91 | 102% |
| Align Senior Care | $93 | 105% |
| Correctional Recovery | $93 | 105% |
| Heartland Hospice | $93 | 105% |
| Hospice Harbor Hospice | $93 | 105% |
| UnitedHealthcare | $96 - $253 | 108% |
| Geha | $101 - $253 | 114% |
| Meritain | $101 | 114% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $105 | 118% |
| Oscar | $119 | 134% |
| Molina Marketplace | $121 | 136% |
| Vitalcore | $144 | 162% |
| Wellpath | $144 | 162% |
| Acs Benefit Services | $150 | 169% |
| Allied Benefit Systems | $150 | 169% |
| Claimchoice Adminstrators | $150 | 169% |
| Consociate | $150 | 169% |
| Cypress Benefit Administrators | $150 | 169% |
| Forest County Potawatomi | $150 | 169% |
| Health Smart | $150 | 169% |
| Healthgram | $150 | 169% |
| Healthscope | $150 | 169% |
| Preferred One | $150 | 169% |
| Secureone Preferred United Plans | $150 | 169% |
| Sisco Benefits | $150 | 169% |
| The Health Plan | $150 | 169% |
| Trustmark Small Business Benefits | $150 | 169% |
| Unified Group Services | $150 | 169% |
| Webtpa | $150 | 169% |
| Asr Health Benefits | $153 | 172% |
| Hap | $153 - $228 | 172% |
| Wc Accident Fund | $154 | 173% |
| Wc Advantage | $154 | 173% |
| Wc Aig | $154 | 173% |
| Wc Allied | $154 | 173% |
| Wc Amerisure | $154 | 173% |
| Wc Amtrust | $154 | 173% |
| Wc Asu Risk Mgt | $154 | 173% |
| Wc Berkley Admin | $154 | 173% |
| Wc Broadspire | $154 | 173% |
| Wc Bunch & Associates | $154 | 173% |
| Wc Ccmsi | $154 | 173% |
| Wc Emc Insurance Company | $154 | 173% |
| Wc Esis | $154 | 173% |
| Wc Fcci | $154 | 173% |
| Wc Federated | $154 | 173% |
| Wc Gallagher Bassett | $154 | 173% |
| Wc Genex Care For Ohio | $154 | 173% |
| Wc Guard Insurance Company | $154 | 173% |
| Wc Hartford | $154 | 173% |
| Wc Liberty Mutual | $154 | 173% |
| Wc Meijers | $154 | 173% |
| Wc Michigan | $154 | 173% |
| Wc Mitchell Frankenmuth | $154 | 173% |
| Wc Pma | $154 | 173% |
| Wc Sedgwick | $154 | 173% |
| Wc Sentry | $154 | 173% |
| Wc Travelers | $154 | 173% |
| Wc Tristar | $154 | 173% |
| Wc Walmart | $154 | 173% |
| Wc Zurich | $154 | 173% |
| Hospice Of Michigan | $158 | 178% |
| Nomi Health | $161 | 181% |
| Varipro | $167 | 188% |
| Caresource | $181 | 204% |
| Cigna | $181 | 204% |
| 1199 National Benefit Fund | $216 | 243% |
| Allied National Global Care | $216 | 243% |
| Asrm - Reliance Standard Life Insurance | $216 | 243% |
| Christian Care Ministry | $216 | 243% |
| Dean Health | $216 | 243% |
| Fallon Health | $216 | 243% |
| Family Life Insurance Company | $216 | 243% |
| Ghc Scw | $216 | 243% |
| Group Pension Administrators | $216 | 243% |
| International Benefit Administrators | $216 | 243% |
| Lifetime Benefit Solutions | $216 | 243% |
| Manhattan Life | $216 | 243% |
| Medi Share | $216 | 243% |
| Multiplan | $216 | 243% |
| Mvp | $216 | 243% |
| Pai | $216 | 243% |
| Pan-American Life | $216 | 243% |
| Paramount Hmo | $216 | 243% |
| Phcs | $216 | 243% |
| Trinity Health Share | $216 | 243% |
| Priority Health | $219 - $245 | 246% |
| Acclaim | $227 | 255% |
| Administrative Concepts | $227 | 255% |
| Allegeant | $227 | 255% |
| Ameriben | $227 | 255% |
| American Family | $227 | 255% |
| American Healthcare Alliance | $227 | 255% |
| American Republic | $227 | 255% |
| Amerihealth | $227 | 255% |
| Aultcare | $227 | 255% |
| Automated Benefit Services | $227 | 255% |
| Auxiant | $227 | 255% |
| Benefit Administrative Systems,Llc | $227 | 255% |
| Boon Chapman | $227 | 255% |
| Cam Administrative Services | $227 | 255% |
| Christian Brother Services | $227 | 255% |
| Christian Brothers Holy Cross | $227 | 255% |
| Comprehensive Benefits | $227 | 255% |
| Continental Life Insurance | $227 | 255% |
| Custom Benefit Administrators | $227 | 255% |
| Employee Benefit Concepts | $227 | 255% |
| Employee Benefit Management | $227 | 255% |
| Enterprise Group Planning | $227 | 255% |
| Freedom Life Insurance Company | $227 | 255% |
| Group Administrators | $227 | 255% |
| Group Marketing Services | $227 | 255% |
| Guardian | $227 | 255% |
| Health America | $227 | 255% |
| Healthez | $227 | 255% |
| Humana | $227 | 255% |
| Insight | $227 | 255% |
| Intercare | $227 | 255% |
| Jfp Benefit Management | $227 | 255% |
| Jp Farley Corporation | $227 | 255% |
| Key Benefit Administrator | $227 | 255% |
| Liberty Union Life Assurance Co | $227 | 255% |
| Lucent Health | $227 | 255% |
| Luminare Health | $227 | 255% |
| Luminare Health (Detroit) | $227 | 255% |
| Medben | $227 | 255% |
| Medcost | $227 | 255% |
| Medical Mutual | $227 | 255% |
| Mutual Health Services | $227 | 255% |
| Mutual Of Omaha | $227 | 255% |
| Ncas | $227 | 255% |
| Nippon Life Ins | $227 | 255% |
| Nova | $227 | 255% |
| Painters Union Insurance Fund | $227 | 255% |
| Physicians Mutual | $227 | 255% |
| Plumbers Local 98 Insurance Fund | $227 | 255% |
| Prairie States | $227 | 255% |
| Primary Physician Care | $227 | 255% |
| Professional Benefit Administrators | $227 | 255% |
| The Loomis Company | $227 | 255% |
| Unicare | $227 | 255% |
| Us Health And Life | $227 | 255% |
| Valenz | $227 | 255% |
| Western & Southern Financial Group | $227 | 255% |
| Wps | $227 | 255% |
| First Health | $236 | 265% |
| Barinet | $288 | 324% |
| Cmh Allegan County | $288 | 324% |
| Cmh Barry County | $288 | 324% |
| Cmh Berrien County | $288 | 324% |
| Cmh Cass County | $288 | 324% |
| Cmh Kalamazoo | $288 | 324% |
| Cmh Kent County | $288 | 324% |
| Cmh Misc | $288 | 324% |
| Cmh Muskegon County | $288 | 324% |
| Cmh North Country | $288 | 324% |
| Cmh Northern Lakes County | $288 | 324% |
| Cmh Ottawa County | $288 | 324% |
| Cmh Van Buren County | $288 | 324% |
| Cmh West Mi County | $288 | 324% |