CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Sanford Worthington Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $195
  • Cash Discount Price: $283
  • vs. Medicare Baseline: 2.19x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Sanford Worthington Medical Center is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $283. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.19x the Medicare baseline. Located in 1018 Sixth Avenue Po Box 997, Worthington, MN.
Cash / Self-Pay
$283

Average discount available for prompt cash payment at this facility.

Insurance Median
$195

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: $283 (318%)
Insurance Median: $195 (219%)
Cash: $283 (318% of Medicare)
Ins. Median: $195 (219% 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 219% of the Medicare baseline (a markup of 119%). 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
Blue Cross Blue Shield $67 - $247 75%
Sanford Health Plan Align $82 92%
Ucare $88 - $276 99%
Aetna $89 - $290 100%
Health Partners $89 - $251 100%
Medicare (plans) $89 100%
UnitedHealthcare $89 - $296 100%
Primewest $91 - $97 102%
Sanford Health Plan $137 - $161 154%
Security Health Plan $195 219%
Medica $316 - $338 355%
First Choice Health Network $319 359%
Healthez $319 359%
Multiplan $319 359%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1018 Sixth Avenue Po Box 997, Worthington, MN 56187
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals