CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Perham Health

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $126
Cash Discount Price: $228
vs. Medicare Baseline: 1.42x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Perham Health is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.42x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$228

Average discount available for prompt cash payment at this facility.

Insurance Median

$126

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: $228 (256%)

Insurance Median: $126 (142%)

Cash: $228 (256% of Medicare)

Ins. Median: $126 (142% 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 Cross Blue Shield	$97 - $237	109%
Health Partners Mcr Adv	$119	134%
Humana	$119	134%
Medica Mcr Adv	$119	134%
Medicare (plans)	$119 - $132	134%
Ucare Mn Senior Health Options	$119	134%
UnitedHealthcare	$122 - $273	137%
Ucare Mn Special Needs Basic Care Dual	$125	141%
Medicaid / KanCare	$126	142%
Ucare Mn Medical Assistance	$126	142%
Ucare Mn Minnesota Care	$126	142%
Ucare Mn Senior Care Plus	$126	142%
Ucare Mn Special Needs Basic Care	$126	142%
Medica Mcaid Mn Care	$128	144%
Medica Mn (Msho)	$144	162%
Ucare Individual And Family Plan-All Other Plans	$145	163%
Medica Mn Senior Hp/Outside Mn	$159	179%
Health Partners Minnesota Care	$175	197%
Medica Commercial-All Other Plans	$256	288%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$262	295%
Health Partners-All Plans	$287	323%
Preferred One (Ppo)	$298	335%
Sanford Health Plan-All Plans	$298	335%

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 $228.
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 Perham 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.