CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Montefiore Mount Vernon Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $109
Cash Discount Price: $438
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Montefiore Mount Vernon Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $438. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.23x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.

Cash / Self-Pay

$438

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $438 (493%)

Insurance Median: $109 (123%)

Cash: $438 (493% of Medicare)

Ins. Median: $109 (123% 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
Emblem	$15 - $539	17%
Fidelis	$15 - $109	17%
Healthfirst	$15 - $109	17%
Medicaid / KanCare	$15	17%
Wellcare	$15 - $111	17%
Vnsny Choice	$17 - $109	19%
Vnsny Select Health	$17	19%
Metroplus	$45 - $141	51%
Blue Cross Blue Shield	$109 - $539	123%
Point Comfort	$109	123%
UnitedHealthcare	$109 - $182	123%
Villagecaremax	$109	123%
Centerlight	$112 - $119	126%
Elderplan	$112	126%
Partners Health Plan	$114	128%
Longevity	$118	133%
Humana	$119	134%
Aetna	$139 - $156	156%
Molina Healthcare Of Ny Affinity	$150	169%
Oscar	$172	193%
American Postal Workers	$182	205%
Cigna	$217 - $241	244%
Mvp	$222	250%
Northwell	$292	328%
Centivo	$425	478%

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 $438.
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 Montefiore Mount Vernon Hospital 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.