CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: M Health Fairview St John's Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $43
Cash Discount Price: $151
vs. Medicare Baseline: 0.48x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at M Health Fairview St John's Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.48x the Medicare baseline. Located in 1575 Beam Avenue, Maplewood, MN.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$43

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: $151 (170%)

Insurance Median: $43 (48%)

Cash: $151 (170% of Medicare)

Ins. Median: $43 (48% 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
Health Partners	$7 - $264	8%
Primewest	$7 - $86	8%
South Country Health Alliance	$7 - $86	8%
Ucare	$7 - $197	8%
Blue Cross Blue Shield	$8 - $174	9%
Itasca Medical Care	$8 - $86	9%
Medica	$8 - $136	9%
Sanford Health Plan	$10 - $221	11%
Security Health Plan	$10 - $282	11%
UnitedHealthcare	$10 - $100	11%
Wellcare	$10 - $86	11%
Hennepin Health	$11 - $89	12%
America'S Ppo	$30 - $271	34%
First Health	$32 - $308	36%
Multiplan	$33 - $320	37%
Private Healthcare Systems	$33 - $320	37%
Wisconsin Physician Services	$35 - $338	39%

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 $151.
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 M Health Fairview St John's 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.