CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Riverview Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $117
Cash Discount Price: $97
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Riverview Medical Center is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.32x the Medicare baseline. Located in One Riverview Plaza, Red Bank, NJ.

Cash / Self-Pay

$97

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $97 (109%)

Insurance Median: $117 (132%)

Cash: $97 (109% of Medicare)

Ins. Median: $117 (132% 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.

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
Karna	$19 - $73	21%
Horizon	$25 - $484	28%
UnitedHealthcare	$45 - $219	51%
Aetna	$61 - $470	69%
Amerihealth	$68 - $69	76%
Blue Cross Blue Shield	$97	109%
Vaccn	$97	109%
Wellcare	$97	109%
Cigna	$102 - $480	115%
United Community/Americhoice	$102	115%
Clover	$108	121%
Seoul Medical Group	$130	146%
Oxford	$219	246%
Qualcare	$298 - $528	335%
Bergen Risk	$450	506%
Brighton Health Plan	$480	540%
Activecare First McO	$510	574%
Multiplan - PHCS	$510	574%

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 $97.
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 Riverview Medical Center 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.