CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Astera Health

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $101
Cash Discount Price: $147
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Astera Health is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.14x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$147

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $147 (165%)

Insurance Median: $101 (114%)

Cash: $147 (165% of Medicare)

Ins. Median: $101 (114% 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
Blue Plus Pmap [40002]	$8 - $5,128	9%
Blue Cross Blue Shield	$11 - $5,128	12%
Health Partners [10045]	$11 - $5,128	12%
Medica Nonpmap [10056]	$11 - $24,029	12%
Primewest Non Pmap [30004]	$11 - $5,128	12%
Ucare Non Pmap [30007]	$11 - $5,385	12%
Sanford Health Plan [10120]	$15 - $262	17%
Ucare Pmap [30006]	$29 - $1,691	33%
Health Partners Pmap [10046]	$30 - $155	34%
Medica Pmap [10057]	$30 - $3,448	34%
Primewest Pmap [30003]	$30 - $3,448	34%
UnitedHealthcare	$37 - $238	42%
Ucare Commercial [10705]	$83 - $229	93%
Multiplan	$90 - $247	101%
Aetna	$101 - $278	114%

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 $147.
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 Astera Health 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.