CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Promedica Monroe Regional Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $87
  • Cash Discount Price: $135
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Promedica Monroe Regional Hospital is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.98x the Medicare baseline. Located in 718 N Macomb St, Monroe, MI.
Cash / Self-Pay
$135

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

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: $135 (152%)
Insurance Median: $87 (98%)
Cash: $135 (152% of Medicare)
Ins. Median: $87 (98% 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.

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 $36 - $146 40%
Blue Cross Blue Shield $36 - $117 40%
Health Alliance Plan $36 - $171 40%
Paramount Healthcare Inc $36 - $158 40%
Priority Health $36 - $114 40%
Humana $38 - $89 43%
Amerihealth $39 44%
Meridian $48 54%
Molina Healthcare Of Michigan $51 57%
UnitedHealthcare $52 - $169 58%
Veterans Affairs $88 99%
Frontpath $121 136%
Encore Health Network $146 164%
Health Ohio Network, Llc $146 164%
Cofinity $148 166%
Multiplan $187 210%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 718 N Macomb St, Monroe, MI 48162
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals