CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mercy St Francis Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $429
Cash Discount Price: $310
vs. Medicare Baseline: 4.83x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mercy St Francis Hospital is $429. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $310. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.83x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.

Cash / Self-Pay

$310

Average discount available for prompt cash payment at this facility.

Insurance Median

$429

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: $310 (349%)

Insurance Median: $429 (483%)

Cash: $310 (349% of Medicare)

Ins. Median: $429 (483% 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 483% of the Medicare baseline (a markup of 383%). 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
Medicaid / KanCare	$49 - $248	55%
Medicare (plans)	$82 - $170	92%
Blue Cross Blue Shield	$83 - $463	93%
UnitedHealthcare	$116 - $453	130%
Tricare	$162	182%
Aetna	$164 - $425	184%
Cherokee Nation Health Serv Contracted [320066]	$164	184%
Cigna	$164 - $453	184%
Cross Timbers Hospice [20098]	$164	184%
Dept Of Veteran Affairs Contracted [320106]	$164	184%
Elara Caring Aspire Hospice [20433]	$164	184%
Globalhealth Contracted [320145]	$164	184%
Halo Hcr Inc Hospice Contracted [320432]	$164	184%
Halo Hcr Inc Hospice [20432]	$164	184%
Humana	$164 - $429	184%
Indian Health Service Contracted [320198]	$164	184%
Kindful Hospice Contracted [320434]	$164	184%
Kindful Hospice [20434]	$164	184%
Medical Associates Health Contracted [320444]	$164	184%
Mercy Hospice Okc [20252]	$164	184%
Mercy Mgd Behavioral Health Contracted [320259]	$164	184%
Pace Of The Ozarks Contracted [320518]	$164	184%
Provider Partners Health Plans Contracted [320450]	$164	184%
Qual Choice Contracted [320325]	$164	184%
Administrative Payor Contracted [320005]	$215	242%
Healthscope Contracted [320182]	$218	245%
Ambetter / Centene	$248	279%
Home State Health Plan Contracted [320187]	$248	279%
Novasys Contracted [320285]	$248	279%
Centivo Contracted [320505]	$277	312%
Healthlink Contracted [320179]	$310 - $453	349%
Preferred Health Plan Contracted [320522]	$310	349%
Workers Comp [20426]	$382 - $405	430%
Auxiant Contracted [320462]	$429 - $453	483%
Mercy Benefit Admin Contracted [320251]	$429 - $453	483%
Point C Contracted [320238]	$429 - $453	483%
United Medical Resources Contracted [320454]	$429 - $444	483%
Medica Contracted [320239]	$451	507%
90 Degree Benefits Contracted [320436]	$453	510%
Aither Health Contracted [320449]	$453	510%
Benefit Management Contracted [320052]	$453	510%
Ebms Contracted [320493]	$453	510%
Edison Health Solutions Contracted [320502]	$453	510%
Evolutions Health Care Contracted [320124]	$453	510%
First Health Contracted [320128]	$453	510%
Health Systems Inc Contracted [320174]	$453	510%
Imagine 360 Contracted [320494]	$453	510%
Insurance System Inc Contracted [320465]	$453	510%
Multiplan Contracted [320270]	$453	510%
Point C [20238]	$453	510%
Private Health Care Systems Contracted [320320]	$453	510%
Reflect Health Contracted [320492]	$453	510%
Show-Me Health Administrators Contracted [320483]	$453	510%
Usa Managed Care Org Contracted [320429]	$453	510%
Yuzu Health Contracted [320521]	$453	510%

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 $310.
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 St Francis Hospital 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.