CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Wooster Community Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $346
  • Cash Discount Price: $433
  • vs. Medicare Baseline: 3.89x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Wooster Community Hospital is $346. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $433. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.89x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$433

Average discount available for prompt cash payment at this facility.

Insurance Median
$346

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: $433 (487%)
Insurance Median: $346 (389%)
Cash: $433 (487% of Medicare)
Ins. Median: $346 (389% 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 389% of the Medicare baseline (a markup of 289%). 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
Buckeye Mcaid-All Other Plans $50 56%
Caresource Mcaid $50 56%
UnitedHealthcare $50 - $411 56%
Blue Cross Blue Shield $51 - $398 57%
Molina Mcaid $51 57%
Aetna $52 - $433 58%
Amerihealth Mcaid-All Plans $52 58%
Tricare $82 92%
Buckeye Mcare $84 94%
Caresource Mcr Adv $84 94%
Humana $84 - $407 94%
Med Mutual Of Oh Mcr $84 94%
Molina Mcr $84 94%
Summacare Mcr $84 94%
The Health Plan Mcr Adv $84 94%
Valor Hp Mcr-All Plans $84 94%
Magnipower-All Plans $109 123%
Caresource Exch - All Other Plans $120 135%
Molina Marketplace - All Other Plans $143 161%
Clarity Health - All Plans $164 184%
Aultcare/Primecare Mcr Adv $212 238%
Cerco-All Plans $303 341%
Aultcare Wayne County $324 364%
Aultcare/Primetime Exch $324 364%
Rayco-All Plans $324 364%
Christian Health Ministries-All Plans $346 389%
Cigna $346 389%
Health Ohio Network Employer $346 389%
Wayne County-All Plans $346 389%
Healthsmart Accel $359 404%
Summacare Preferred Choice $359 404%
Health Ohio Network Ppo-All Other Plans $368 414%
Healthsmart Complete Ppo-All Other Plans $368 414%
Ohio Health Choice Supp $368 414%
Ohio Health Group Hlthy - All Other Plans $368 414%
Med Mutual Of Oh Exchange $372 418%
Med Mutual Of Oh Supermed $372 418%
Med Mutual Of Oh Trad-All Other Plans $372 418%
Health Plan Of Upper Ohio-All Plans $381 429%
The Health Plan Comm - All Other Plans $381 429%
Ohio Health Group Pref $385 433%
Aultcare/Primetime-All Other Plans $389 438%
Healthsmart Ppo $394 443%
Summacare-All Other Plans $402 452%
Ohio Health Choice-All Other Plans $407 458%
Healthsmart Hpo $411 462%
Osu-All Plans $411 462%
Central Benefits-All Plans $415 467%
First Health-All Plans $415 467%
Flora-All Plans $415 467%
Beech Street-All Plans $420 472%
Phcs-All Plans $420 472%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals