CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $44
Cash Discount Price: $267
vs. Medicare Baseline: 0.49x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Munson Healthcare Otsego Memorial Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $267. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.49x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$267

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $267 (300%)

Insurance Median: $44 (49%)

Cash: $267 (300% of Medicare)

Ins. Median: $44 (49% 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	$7 - $196	8%
Mclaren Health Plan	$7 - $263	8%
Meridian	$7 - $45	8%
Molina	$7 - $94	8%
Priority Health	$7 - $97	8%
UnitedHealthcare	$7 - $252	8%
Aetna	$10 - $254	11%
Blue Care Network	$10 - $87	11%
Hap (Health Alliance Plan)	$10 - $251	11%
Humana	$10 - $87	11%
Medicare (plans)	$10 - $87	11%
Michigan Amish Medical Board	$10 - $87	11%
Northern Michigan Mennonite Group	$10 - $87	11%
Asr Physicians Care Network	$15 - $251	17%
Cigna	$16 - $97	18%
Nomi Health	$16 - $251	18%
Employee Benefit Logistics	$17 - $147	19%
Munson Hospice	$157 - $852	177%
Hospice Of Michigan	$188	211%
Enterprise Group Planning/Employee Benefit Plan	$251	282%
Cofinity	$267	300%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$267	300%
Three Rivers Provider Network	$267	300%

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 $267.
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 Munson Healthcare Otsego Memorial 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.