CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: St Louis Childrens Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $223
Cash Discount Price: $181
vs. Medicare Baseline: 2.51x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at St Louis Childrens Hospital is $223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $181. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.51x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.

Cash / Self-Pay

$181

Average discount available for prompt cash payment at this facility.

Insurance Median

$223

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: $181 (204%)

Insurance Median: $223 (251%)

Cash: $181 (204% of Medicare)

Ins. Median: $223 (251% 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 251% of the Medicare baseline (a markup of 151%). 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	$86 - $239	97%
Blue Cross Blue Shield	$86 - $257	97%
Essence Healthcare [221]	$86	97%
Humana	$86 - $225	97%
UnitedHealthcare	$86 - $224	97%
Cox Health [757]	$90	101%
Medica [662]	$90	101%
Healthlink [225]	$146 - $228	164%
Cigna	$149 - $164	168%
Apwu Health Plan [216]	$164	184%
Consociate [478]	$164	184%
Nalc Health Benefit Plan [242]	$164	184%
Priority Health [648]	$164	184%
Sarah Bush Lincoln [636]	$164	184%
Allied Benefits [498]	$175 - $239	197%
Hope Trust [806]	$175	197%
Cox Health Systems Insurance Company [220]	$196 - $223	220%
Med-Pay [480]	$196 - $226	220%
Unicare [568]	$196 - $228	220%
Health Alliance [224]	$211	237%
Healthscope Benefits [258]	$215 - $242	242%
First Health Commercial [734]	$224	252%
Beechstreet [551]	$226	254%
Detego Health [868]	$226	254%
Health Systems Inc [620]	$226	254%
Healthcare Sol Mercy [609]	$226	254%
Multiplan Commercial [737]	$226	254%
Multiplan [240]	$226	254%
Phcs [244]	$226 - $242	254%
Preferred Health Professionals [561]	$228	256%
Coresource [497]	$239	269%
Fmh Benefit Service Inc [222]	$239	269%
Mail Handlers [495]	$239	269%
Medica [661]	$242	272%
Hfn [563]	$257	289%

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 $181.
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 St Louis Childrens 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.