CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Elizabethtown Community Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $50
Cash Discount Price: $272
vs. Medicare Baseline: 0.56x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Elizabethtown Community Hospital is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $272. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.56x the Medicare baseline. Located in 75 Park Street, Elizabethtown, NY.

Cash / Self-Pay

$272

Average discount available for prompt cash payment at this facility.

Insurance Median

$50

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: $272 (306%)

Insurance Median: $50 (56%)

Cash: $272 (306% of Medicare)

Ins. Median: $50 (56% 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
Capital District Physicians' Health Plan	$25 - $421	28%
Harvard Pilgrim	$26 - $410	29%
Magnacare	$26 - $410	29%
UnitedHealthcare	$26 - $472	29%
Blue Cross Blue Shield	$27 - $385	30%
Coventry	$27 - $435	30%
Fidelis Care	$27 - $195	30%
Multiplan	$29 - $461	33%
Mvp	$31 - $400	35%
Humana	$35 - $84	39%
Aetna	$37 - $384	42%
Martins Point	$37 - $195	42%
Veterans Affairs Community Care Network	$37 - $195	42%
Choicecare	$40 - $410	45%
Highmark Blueshield	$42 - $417	47%
Wellpath	$51 - $292	57%
Emblem Health	$410	461%

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 $272.
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 Elizabethtown Community 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.