CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Sanford Medical Center Fargo

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $268
Cash Discount Price: $446
vs. Medicare Baseline: 3.01x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Sanford Medical Center Fargo is $268. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $446. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.01x the Medicare baseline. Located in 801 Broadway North, Fargo, ND.

Cash / Self-Pay

$446

Average discount available for prompt cash payment at this facility.

Insurance Median

$268

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: $446 (502%)

Insurance Median: $268 (301%)

Cash: $446 (502% of Medicare)

Ins. Median: $268 (301% 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 301% of the Medicare baseline (a markup of 201%). 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
Sanford Health Plan	$40	45%
Blue Cross Blue Shield	$66 - $160	74%
Sanford Health Plan Align	$84	94%
Ucare	$90 - $392	101%
Aetna	$91 - $476	102%
Health Partners	$91 - $228	102%
Medicare (plans)	$91	102%
UnitedHealthcare	$91 - $485	102%
Primewest	$92 - $95	103%
Medica	$251 - $268	282%
Security Health Plan	$306	344%
Cigna	$501	563%
First Choice Health Network	$501	563%
Healthez	$501	563%
Multiplan	$501	563%

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 $446.
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 Sanford Medical Center Fargo 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.