CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $16
Cash Discount Price: $150
vs. Medicare Baseline: 0.18x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at The University of Vermont Health Network-Alice Hy is $16. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.18x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$16

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: $150 (169%)

Insurance Median: $16 (18%)

Cash: $150 (169% of Medicare)

Ins. Median: $16 (18% 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
Blue Cross Blue Shield	$6 - $285	7%
Capital District Physicians' Health Plan	$7 - $268	8%
UnitedHealthcare	$7 - $281	8%
Fidelis Care	$9 - $91	10%
Humana	$9 - $91	10%
Mvp	$9 - $91	10%
Aetna	$10 - $245	11%
Martins Point	$10 - $91	11%
Veterans Affairs Community Care Network	$10 - $91	11%
Choicecare	$11 - $214	12%
Magnacare	$11 - $228	12%
Highmark Blueshield	$14 - $255	16%
St. Regis	$24 - $91	27%

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 $150.
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 The University of Vermont Health Network-Alice Hy 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.