CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Children's Specialized Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $320
  • Cash Discount Price: $208
  • vs. Medicare Baseline: 3.60x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Children's Specialized Hospital is $320. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $208. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.60x the Medicare baseline. Located in 200 Somerset St, New Brunswick, NJ.
Cash / Self-Pay
$208

Average discount available for prompt cash payment at this facility.

Insurance Median
$320

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: $208 (234%)
Insurance Median: $320 (360%)
Cash: $208 (234% of Medicare)
Ins. Median: $320 (360% 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 360% of the Medicare baseline (a markup of 260%). 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 $18 - $408 20%
First Health $250 281%
Cigna $251 282%
Emblem Health $283 318%
Amerihealth $315 354%
Aetna $318 - $320 358%
Fidelis Care $318 358%
Wellpoint $318 358%
Qualcare Inc $324 364%
UnitedHealthcare $328 - $770 369%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Somerset St, New Brunswick, NJ 08901
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens