CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: University of Michigan Health - West

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $261
Cash Discount Price: $156
vs. Medicare Baseline: 2.94x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at University of Michigan Health - West is $261. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.94x the Medicare baseline. Located in 5900 Byron Center Avenue, Sw, Wyoming, MI.

Cash / Self-Pay

$156

Average discount available for prompt cash payment at this facility.

Insurance Median

$261

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: $156 (175%)

Insurance Median: $261 (294%)

Cash: $156 (175% of Medicare)

Ins. Median: $261 (294% 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 294% of the Medicare baseline (a markup of 194%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$48 - $92	54%
Molina Healthcare Of Mi	$48	54%
Care Resources	$80	90%
Priority Health	$84	94%
Humana	$89 - $292	100%
Insight Metro Care	$89	100%
Medicare (plans)	$89	100%
Molina Marketplace Commercial	$89	100%
Web Tpa	$171	192%
Aetna	$182 - $261	205%
Alliance Health & Life Ppo	$261	294%
Asr Physicians	$261	294%
Hap	$261	294%
Golden Rule Ins	$280	315%
Medica	$280	315%
Student Ins/Mega Life	$280	315%
UnitedHealthcare	$280	315%
Asr Cofinity	$325	366%
Cofinity Commercial	$325	366%
Cofinity Weyco	$325	366%
Core Source	$325	366%
Epoch Group	$325	366%
Health Partners	$325	366%
Hlthcomp Admin	$325	366%
Mid America	$325	366%

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 $156.
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 University of Michigan Health - West 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.