CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Pender Memorial Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $78
Cash Discount Price: $122
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Pender Memorial Hospital is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.88x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$122

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $122 (137%)

Insurance Median: $78 (88%)

Cash: $122 (137% of Medicare)

Ins. Median: $78 (88% 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	$33 - $100	37%
Humana	$70 - $233	79%
Pace Of The Southern Piedmont	$73	82%
Aetna	$75 - $230	84%
Cigna	$75 - $120	84%
New Hanover Health	$75	84%
Carolina Complete	$76	85%
Nc Department Of Public Safety	$76 - $146	85%
Amerihealth	$78	88%
Wellcare	$78	88%
Ambetter / Centene	$102	115%
Liberty Health	$104	117%
Caresource North Carolina	$108	121%
Plotkin Health	$163	183%
UnitedHealthcare	$198	223%
Medcost	$204 - $227	229%
Employers Choice Network	$263	296%
Three Rivers Provider Network	$263	296%

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 $122.
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 Pender Memorial 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.