CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Portsmouth Regional Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $335
  • Cash Discount Price: $1,177
  • vs. Medicare Baseline: 3.77x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Portsmouth Regional Hospital is $335. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,177. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.77x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.
Cash / Self-Pay
$1,177

Average discount available for prompt cash payment at this facility.

Insurance Median
$335

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: $1,177 (1324%)
Insurance Median: $335 (377%)
Cash: $1,177 (1324% of Medicare)
Ins. Median: $335 (377% 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 377% of the Medicare baseline (a markup of 277%). 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 $45 - $521 51%
Amerihealth Caritas $48 54%
Well Sense Health Plan $96 108%
Harvard Pilgrim $214 - $268 241%
United $302 - $777 340%
Maine Community Health $368 - $624 414%
Tufts Health Plan $443 - $673 498%
Cigna $727 818%
Aetna $745 838%
Mvp Health Plan $824 927%
Corvel $847 953%
Evernorth $942 1059%
Mutual Of Omaha $942 1059%
Multiplan $953 1072%
First Health $1,071 1205%
Healthcare Value Mgmt $1,071 1205%
Oxford Health Plans $1,118 1257%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 333 Borthwick Ave, Portsmouth, NH 03801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals