CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Essentia Health Northern Pines Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $233
Cash Discount Price: $248
vs. Medicare Baseline: 2.62x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Essentia Health Northern Pines Medical Center is $233. 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 2.62x the Medicare baseline. Located in 5211 Highway 110, Aurora, MN.

Cash / Self-Pay

$248

Average discount available for prompt cash payment at this facility.

Insurance Median

$233

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: $233 (262%)

Cash: $248 (279% of Medicare)

Ins. Median: $233 (262% 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 262% of the Medicare baseline (a markup of 162%). 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
Itasca Med Care	$88	99%
Primewest	$88	99%
Blue Cross Blue Shield	$129 - $270	145%
Blue Plus Pmap Pcc Prime	$129 - $185	145%
Advocare/Security Health	$131	147%
Freedom Blue Ppo	$131	147%
Healthpartners Care Msho / Mcr Adv	$131	147%
Imcare Msho Pcc Prime	$131	147%
Imcare Msho Ref Req	$131	147%
Medica Advantage Solutions	$131	147%
Medica Msho/Dual Solutions	$131	147%
Medica Prime Solution Group	$131	147%
Medicare (plans)	$131	147%
Nd Va Administration	$131	147%
Platinum Blue/Vantage Blue	$131	147%
Primewest Msho	$131	147%
Secure Blue Msho	$131	147%
Ubh Cost Plan	$131	147%
Ubh Msho	$131	147%
Ucare Msho	$131	147%
UnitedHealthcare	$131 - $304	147%
Medica Access	$134 - $209	151%
Healthpartners Care Pmap	$135	152%
Sanford Healthplan	$144 - $152	162%
Ucare	$221	249%
Healthpartners	$227 - $268	255%
Medica	$240 - $267	270%
Medica Uplan	$240	270%
Wea	$242 - $259	272%
America'S Ppo	$260	292%
Cigna	$262 - $268	295%
Healthpartners Pcc Prime	$262 - $268	295%
Medica Choice	$275	309%
Wps	$279 - $282	314%
Aetna	$286	322%
Healtheos	$289	325%
Security Health	$336	378%

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 $248.
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 Essentia Health Northern Pines Medical Center 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.