CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Licking Memorial Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $668
  • Cash Discount Price: $816
  • vs. Medicare Baseline: 7.51x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Licking Memorial Hospital is $668. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $816. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 7.51x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$816

Average discount available for prompt cash payment at this facility.

Insurance Median
$668

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: $816 (918%)
Insurance Median: $668 (751%)
Cash: $816 (918% of Medicare)
Ins. Median: $668 (751% 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 751% of the Medicare baseline (a markup of 651%). 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
Tricare $82 92%
Aetna $84 - $674 94%
Blue Cross Blue Shield $84 - $701 94%
Champva [500001] $84 94%
Cigna $84 - $735 94%
Humana $84 - $792 94%
Medicare (plans) $84 94%
UnitedHealthcare $84 - $694 94%
Veterans Administration [100068] $84 94%
Wellcare By Allwell [450104] $84 94%
Molina Marketplace [100106] $134 151%
Medical Mutual [100114] $449 - $678 505%
Medben [700068] $572 - $800 643%
Benicomp [70090] $612 688%
Consociate Health 6 Degrees [100059] $653 734%
Consociate Health [100029] $653 734%
Allied Benefit Systems [100015] $668 751%
Geha [100039] $668 751%
Gravie Administrative Services [100165] $668 751%
Meritain [100063] $668 751%
Optima [700069] $668 751%
Trustmark Small Business Benefits [100263] $668 751%
Webtpa [100127] $668 751%
Healthscope [100157] $694 781%
Surest [100016] $694 781%
United Medical Resources [700071] $694 781%
American Postal Workers [100089] $735 827%
Antidote Health Plan Of Ohio [70006803] $735 827%
Coresource [100002] $735 - $816 827%
Great West Life [700064] $735 827%
National Association Of Letter Carriers [100067] $735 827%
Ohio Healthy Luminare Health [100264] $735 827%
Ohio Healthy [100255] $735 827%
Ohio Ppo Connect [70006801] $735 827%
Osu Prime Care [100254] $735 827%
Quality Care Partners [70006802] $735 827%
The Health Plan [100261] $735 827%
Wellfleet Group, Llc [100164] $735 827%
Coventry [100010] $754 848%
Pan American Life [700070] $754 848%
Ohio Health Choice [100109] $784 882%
Administrative Concepts [100006] $792 891%
Carefactor [100087] $792 891%
Philadelphia American Life [100260] $792 - $816 891%
Reliance Standard-Asrm [100258] $792 891%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals