CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Essentia Health Ada

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $221
  • Cash Discount Price: $248
  • vs. Medicare Baseline: 2.49x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Essentia Health Ada is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $248. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.49x the Medicare baseline. Located in 201 9Th Street West, Ada, MN.
Cash / Self-Pay
$248

Average discount available for prompt cash payment at this facility.

Insurance Median
$221

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: $248 (279%)
Insurance Median: $221 (249%)
Cash: $248 (279% of Medicare)
Ins. Median: $221 (249% 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 249% of the Medicare baseline (a markup of 149%). 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
Itasca Med Care $88 99%
Primewest $88 99%
Healthpartners Care Pmap $131 147%
Medica Access $134 - $209 151%
Sanford Health Plan $144 - $152 162%
Advocare/Security Health $161 181%
Blue Cross Blue Shield $161 - $293 181%
Freedom Blue Ppo $161 181%
Healthpartners Care Msho / Mcr Adv $161 181%
Imcare Msho Pcc Prime $161 181%
Imcare Msho Ref Req $161 181%
Medica Advantage Solutions $161 181%
Medica Msho/Dual Solutions $161 181%
Medica Prime Solution Group $161 181%
Medicare (plans) $161 181%
Nd Va Administration $161 181%
Platinum Blue/Vantage Blue $161 181%
Primewest Msho $161 181%
Secure Blue Msho $161 181%
Ubh Cost Plan $161 181%
Ubh Msho $161 181%
Ucare Msho $161 181%
UnitedHealthcare $161 - $304 181%
Blue Plus Pmap Pcc Prime $185 - $293 208%
Healthpartners $204 - $223 229%
Ucare $221 249%
Cigna $223 251%
Healthpartners Pcc Prime $223 251%
Wea $242 - $259 272%
America'S Ppo $260 292%
Medica $279 - $294 314%
Medica Uplan $279 314%
Wps $279 - $282 314%
Aetna $286 322%
Medica Choice $303 341%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 9Th Street West, Ada, MN 56510
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals