CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Blue Ridge Regional Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $399
  • Cash Discount Price: $983
  • vs. Medicare Baseline: 4.49x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Blue Ridge Regional Hospital is $399. 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 4.49x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$983

Average discount available for prompt cash payment at this facility.

Insurance Median
$399

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: $399 (449%)
Cash: $983 (1106% of Medicare)
Ins. Median: $399 (449% 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 449% of the Medicare baseline (a markup of 349%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $157 - $165 177%
United $167 - $465 188%
Wellcare $170 191%
Amerihealth $172 193%
Partners Health Management $173 195%
Vaya Health $173 195%
Aetna $197 - $711 222%
Apex Health $197 222%
Cigna $334 - $402 376%
Amerihealth Caritas $364 409%
Caresource $432 486%
Medcost $458 - $509 515%
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

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals