CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Maple Grove Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $161
Cash Discount Price: $191
vs. Medicare Baseline: 1.81x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Maple Grove Hospital is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.81x the Medicare baseline. Located in 9875 Hospital Drive, Maple Grove, MN.

Cash / Self-Pay

$191

Average discount available for prompt cash payment at this facility.

Insurance Median

$161

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: $191 (215%)

Insurance Median: $161 (181%)

Cash: $191 (215% of Medicare)

Ins. Median: $161 (181% 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 [1061]	$61 - $168	69%
Blue Cross Blue Shield	$70 - $161	79%
Medicaid / KanCare	$81	91%
Humana	$89	100%
Medicare (plans)	$89	100%
Ucare [1148]	$89 - $163	100%
Medica [1086]	$90 - $892	101%
UnitedHealthcare	$93 - $217	105%
Aetna	$97 - $272	109%
Cigna	$168	189%
America'S Ppo [1010]	$245 - $261	276%
Phcs [1172]	$272	306%
Multiplan [1176]	$290	326%

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 $191.
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 Maple Grove 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.