CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Transylvania Regional Hospital, Inc

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $403
Cash Discount Price: $983
vs. Medicare Baseline: 4.53x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Transylvania Regional Hospital, Inc is $403. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $983. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.53x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.

Cash / Self-Pay

$983

Average discount available for prompt cash payment at this facility.

Insurance Median

$403

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: $983 (1106%)

Insurance Median: $403 (453%)

Cash: $983 (1106% of Medicare)

Ins. Median: $403 (453% 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 453% of the Medicare baseline (a markup of 353%). 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	$186 - $197	209%
United	$188 - $442	211%
Wellcare	$191	215%
Amerihealth	$193	217%
Partners Health Management	$195	219%
Vaya Health	$195	219%
Apex Health	$197	222%
Aetna	$256 - $711	288%
Cigna	$360 - $500	405%
Amerihealth Caritas	$403	453%
Caresource	$432	486%
Medcost	$550 - $835	619%
Magellan	$590	664%
Magellan Behavioral Health	$590	664%
Multiplan	$786	884%
Avalon Administrative Services	$835	939%
Prime Health	$865 - $885	973%

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 $983.
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 Transylvania Regional Hospital, Inc 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.