CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mercy Hospital - Cassville

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $381
Cash Discount Price: $309
vs. Medicare Baseline: 4.29x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mercy Hospital - Cassville is $381. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $309. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.29x the Medicare baseline. Located in 94 Main Street, Cassville, MO.

Cash / Self-Pay

$309

Average discount available for prompt cash payment at this facility.

Insurance Median

$381

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: $309 (348%)

Insurance Median: $381 (429%)

Cash: $309 (348% of Medicare)

Ins. Median: $381 (429% 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 429% of the Medicare baseline (a markup of 329%). 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
Aetna	$24 - $424	27%
Humana	$24 - $405	27%
Medicaid / KanCare	$24 - $248	27%
Medicare (plans)	$82 - $204	92%
Blue Cross Blue Shield	$83 - $462	93%
UnitedHealthcare	$116 - $452	130%
Dept Of Veteran Affairs Contracted [320106]	$162	182%
Tricare	$193	217%
Cherokee Nation Health Serv Contracted [320066]	$196	220%
Cigna	$196 - $452	220%
Cross Timbers Hospice [20098]	$196	220%
Elara Caring Aspire Hospice [20433]	$196	220%
Globalhealth Contracted [320145]	$196	220%
Halo Hcr Inc Hospice Contracted [320432]	$196	220%
Halo Hcr Inc Hospice [20432]	$196	220%
Indian Health Service Contracted [320198]	$196	220%
Kindful Hospice Contracted [320434]	$196	220%
Kindful Hospice [20434]	$196	220%
Medical Associates Health Contracted [320444]	$196	220%
Mercy Hospice Okc [20252]	$196	220%
Mercy Mgd Behavioral Health Contracted [320259]	$196	220%
Pace Of The Ozarks Contracted [320518]	$196	220%
Provider Partners Health Plans Contracted [320450]	$196	220%
Qual Choice Contracted [320325]	$196	220%
Healthscope Contracted [320182]	$199	224%
Administrative Payor Contracted [320005]	$214	241%
Centivo Contracted [320505]	$243	273%
Ambetter / Centene	$248	279%
Home State Health Plan Contracted [320187]	$248	279%
Novasys Contracted [320285]	$248	279%
Healthlink Contracted [320179]	$309 - $428	348%
Preferred Health Plan Contracted [320522]	$309	348%
Health Systems Inc Contracted [320174]	$381	429%
Insurance System Inc Contracted [320465]	$381	429%
Point C Contracted [320238]	$381 - $428	429%
Point C [20238]	$381	429%
United Medical Resources Contracted [320454]	$381 - $405	429%
Workers Comp [20426]	$381 - $428	429%
Municipal Health Plan Contracted [320271]	$386	434%
Medica Contracted [320239]	$426	479%
90 Degree Benefits Contracted [320436]	$428	481%
Aither Health Contracted [320449]	$428	481%
American Healthcare Alliance Contracted [320020]	$428	481%
Auxiant Contracted [320462]	$428	481%
Benefit Management Contracted [320052]	$428	481%
Ebms Contracted [320493]	$428	481%
Edison Health Solutions Contracted [320502]	$428	481%
Evolutions Health Care Contracted [320124]	$428	481%
Imagine 360 Contracted [320494]	$428	481%
Mercy Benefit Admin Contracted [320251]	$428	481%
Reflect Health Contracted [320492]	$428	481%
Show-Me Health Administrators Contracted [320483]	$428	481%
Usa Managed Care Org Contracted [320429]	$428	481%
Yuzu Health Contracted [320521]	$428	481%
First Health Contracted [320128]	$452	508%
Multiplan Contracted [320270]	$452	508%
Private Health Care Systems Contracted [320320]	$452	508%

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 $309.
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 Mercy Hospital - Cassville 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.