CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: The McDowell Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $433
Cash Discount Price: $934
vs. Medicare Baseline: 4.87x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at The McDowell Hospital is $433. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $934. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.87x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.

Cash / Self-Pay

$934

Average discount available for prompt cash payment at this facility.

Insurance Median

$433

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: $934 (1051%)

Insurance Median: $433 (487%)

Cash: $934 (1051% of Medicare)

Ins. Median: $433 (487% 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 487% of the Medicare baseline (a markup of 387%). 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
Blue Cross Blue Shield	$118 - $131	133%
United	$120 - $505	135%
Wellcare	$121 - $135	136%
Amerihealth	$123 - $136	138%
Partners Health Management	$124 - $138	139%
Vaya Health	$124 - $138	139%
Apex Health	$177 - $197	199%
Cigna	$304 - $526	342%
Caresource	$390 - $432	439%
Medcost	$434 - $835	488%
Magellan	$531 - $590	597%
Magellan Behavioral Health	$531 - $590	597%
Aetna	$640 - $711	720%
Multiplan	$708 - $786	796%
Avalon Administrative Services	$753 - $835	847%
Prime Health	$779 - $885	876%

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 $934.
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 The McDowell 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.