CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Newton Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $116
  • Cash Discount Price: $106
  • vs. Medicare Baseline: 1.30x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Newton Medical Center is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.30x the Medicare baseline. Located in 175 High St, Newton, NJ.
Cash / Self-Pay
$106

Average discount available for prompt cash payment at this facility.

Insurance Median
$116

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: $106 (119%)
Insurance Median: $116 (130%)
Cash: $106 (119% of Medicare)
Ins. Median: $116 (130% 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.

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 $28 - $1,042 31%
Prime Healthcare [5435] $30 34%
Independence Bc [5479] $30 34%
Qualcare [5026] $33 - $798 37%
Horizon Nj Health [5021] $60 67%
Aetna $65 - $163 73%
Cigna $72 - $116 81%
Wtc Health Program [5273] $74 83%
Boon-Chapman [5441] $83 93%
1199 Seiu Benefit and Pension [5037] $83 93%
Evolution Healthcare [5438] $83 - $85 93%
Allied Benefit Systems [5046] $83 - $94 93%
Christian Brothers Services [5439] $83 93%
Luminare Health Benefits [5483] $83 93%
Healthez [5445] $83 - $85 93%
Webtpa [5447] $83 - $85 93%
Meritain Health [5185] $83 93%
Marpai Health [5449] $83 93%
Banner Health Network [5510] $83 93%
Nippon Benefit Life [5201] $83 93%
Starmark [5240] $83 93%
Continental Assurance [5091] $83 93%
Healthsmart Benefit Solutions [5446] $83 93%
Mvp Health Care [5197] $85 96%
Nalc [5198] $85 96%
Seafarers Health and Benefits Plan [5343] $85 96%
Tufts Health Plan [5344] $85 96%
Iaa - Insurance Administrators of America [5482] $94 106%
Centivo [5405] $94 - $238 106%
Medicare (plans) $96 - $120 108%
Amerihealth Administrators Supplemental [5512] $96 - $116 108%
Wellcare Health Plans [5269] $96 - $116 108%
Cosmetic Surgery/Lap Band/Gastric Bypass [5289] $96 - $116 108%
Fairos [5491] $96 - $116 108%
Highmark Wholecare Health Plan [5413] $96 - $116 108%
Ambetter / Centene $96 - $116 108%
Amerihealth Medigap [5049] $96 - $116 108%
Tricare $96 - $116 108%
UPMC [5455] $96 - $116 108%
Wellcare Behavioral Health [5335] $96 - $116 108%
VA Community Care Network [5403] $96 - $116 108%
Champva [5354] $96 - $116 108%
Sedgwick Wtc Health Program Wc [5514] $96 - $116 108%
Medicaid / KanCare $96 - $118 108%
Claimdoc [5434] $96 - $116 108%
Karen Ann Quinlan [5285] $96 - $116 108%
Specialty Imaging [5433] $96 - $116 108%
Claim Watcher/Homestead [5488] $96 - $767 108%
Us Family Health Plan [5258] $96 - $116 108%
Wellcare Health Plans Ip Splits [5475] $96 - $116 108%
Luminare Health AHS Retiree [5013] $96 - $116 108%
Highmark Wholecare Health Plan Ip Splits [5464] $96 - $116 108%
Amerihealth Caritas Vip Care Ip Splits [5460] $97 - $117 109%
Amerihealth Caritas Vip Care [5313] $97 - $117 109%
Kindred Giralda Hospital [5341] $106 - $128 119%
Untd Hlth Community Plan [5034] $113 127%
Untd Hlth Community Plan Behavioral Health [5293] $113 127%
Harvard Pilgrim Healthcare [5133] $132 148%
Geha [5119] $132 148%
Surest [5437] $132 148%
Apwu Healthcare [5053] $132 148%
UnitedHealthcare $132 148%
Ntca [5208] $132 148%
Oxford [5024] $132 148%
Oxford Behavioral Health [5291] $132 148%
Golden Rule Insurance [5124] $132 148%
Plymouth Rock Assurance No Fault [5222] $178 200%
Medlogix/Consumer Health Network Pip (Chn) [5414] $178 200%
High Point No Fault [5146] $178 200%
Travelers Workers Compensation [5250] $767 863%
The Fairly Group [5528] $767 863%
Praxis Workers Comp [5515] $767 - $1,150 863%
Occunet [5490] $767 863%
Medlogix/Consumer Health Network (Chn) [5415] $767 - $1,304 863%
Sedgwick [5235] $767 863%
First Managed Care Option [5109] $767 - $1,304 863%
Magnacare [5177] $767 - $1,227 863%
Sentry Worker's Comp [5489] $767 863%
Inservco Workers Compensation [5158] $767 - $1,304 863%
Gallagher Bassett Workers Comp [5117] $767 863%
Liberty Mutual Worker's Comp [5174] $767 863%
Pma Workers Comp [5224] $767 863%
Humana $798 898%
Ghi Emblem Health [5122] $798 898%
Oscar [5213] $798 898%
Ila Local 1478-2 Welfare Fund [5448] $798 898%
Amerihealth [5008] $828 931%
Coresource [5014] $844 949%
Continental Assurance - PHCS [5092] $844 949%
Kaiser Permanente [5162] $844 949%
Private Healthcare Systems PPO (PHCS) [5227] $844 949%
Continental Casualty PHCS [5094] $844 949%
Selective Ins Workers Comp [5237] $865 973%
Nj Manufacturers Workers Comp [5204] $865 973%
Hartford Worker's Compensation [5132] $865 973%
Church Mutual Wc Insurance Company [5524] $865 973%
Hcs Network Solutions [5148] $865 973%
Hanover Workers Comp [5130] $865 973%
Strategic Comp [5518] $865 973%
Zurich Workers Comp [5275] $865 973%
Allstate [5047] $916 1030%
Geico No Fault [5120] $916 1030%
Usaa No Fault [5260] $916 1030%
Travelers No Fault [5249] $916 1030%
Zurich No Fault [5274] $916 1030%
Liberty Mutual No Fault [5173] $916 1030%
Esurance No Fault [5105] $916 1030%
Progressive No Fault [5229] $916 1030%
State Farm No Fault [5241] $916 1030%
Hanover No Fault [5129] $916 1030%
Nj Manufacturers No Fault [5203] $916 1030%
Occunet Secondary [5517] $920 1035%
The Fairly Group Secondary [5531] $920 1035%
First Health Network [5108] $997 1121%
One Call Workers Comp [5418] $1,074 1208%
Multiplan [5194] $1,074 1208%
Aig Workers Compensation [5045] $1,150 1293%
Sage Adjusting, LLC [5527] $1,150 1293%
Qual-Lynx Wc Preferred [5230] $1,150 1293%
Qual-Lynx Wc Standard [5028] $1,150 1293%
Ccmsi Wc [5525] $1,150 1293%
Amtrust North America Inc [5521] $1,150 1293%
Broadspire Workers Comp [5357] $1,150 1293%
Nationwide Mutual Insurance Company [5526] $1,150 1293%
Berkshire Hathaway Guard Insurance Company [5529] $1,150 1293%
Chubb Worker's Compensation [5075] $1,304 1467%
Esis [5519] $1,304 1467%
Medrisk/Spnet Worker's Comp [5452] $1,304 1467%
Claims Resolution Corporation Inc [5520] $1,304 1467%
Corvel Corporation [5522] $1,304 1467%
Kessler Foundation [5532] $1,534 1725%
Carisk Worker's Comp [5501] $1,534 1725%
Carba R Generic [5530] $1,534 1725%
Atlantic Home Care and Hospice [5055] $1,534 1725%
Bundled Cases/Episodic Payment [5492] $1,534 1725%
Streamline Worker's Comp [5540] $1,534 1725%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 175 High St, Newton, NJ 07860
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals