CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Englewood Hospital and Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $187
Cash Discount Price: $111
vs. Medicare Baseline: 2.10x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Englewood Hospital and Medical Center is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.10x the Medicare baseline. Located in 350 Engle St, Englewood, NJ.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$187

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: $111 (125%)

Insurance Median: $187 (210%)

Cash: $111 (125% of Medicare)

Ins. Median: $187 (210% 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 210% of the Medicare baseline (a markup of 110%). 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
Multiplan	$12 - $544	13%
Emblem_762	$23	26%
Horizon New Jersey Health - Dsnp	$81 - $104	91%
Wellcare_755	$87	98%
Hip Health Plan	$93 - $99	105%
Aetna	$94 - $547	106%
Heathnet Federal Services	$95	107%
Americhoice_756	$100	112%
Americhoice_732	$104	117%
Amerigroup_758	$104	117%
Amerihealth_766	$104	117%
Blue Cross Blue Shield	$104 - $644	117%
Clover_733	$104	117%
Humana	$104	117%
UnitedHealthcare	$104 - $199	117%
Amerigroup_754	$109	123%
Emblem_734	$110	124%
Wellcare_765	$112	126%
Health Care Support_787	$181	204%
Amerihealth_760	$187	210%
Magnacare_768	$223	251%
Magnacare_770	$223	251%
Oxford_741	$226	254%
Amerihealth_757	$510	574%
Horizon	$650 - $693	731%
Magnacare_763	$667	750%
Magnacare_769	$667	750%
Cigna	$716	805%
Qualcare_752	$734	826%
Qualcare	$744	837%
Bergen	$833	937%
Coventry	$833	937%
Magnacare	$889	1000%
Qualcare_783	$7,783	8754%

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 $111.
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 Englewood Hospital and 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.