CMS Price Transparency Data
X-ray, neck (cervical spine)
Facility: Diley Ridge Medical Center
Billing Code: 72040 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 72040
- Insurance Median: $180
- Cash Discount Price: $250
- vs. Medicare Baseline: 2.02x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Diley Ridge Medical Center is $180. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $250. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.02x the Medicare baseline. Located in 7911 Diley Road, Canal Winchester, OH.
Cash / Self-Pay
$250
Average discount available for prompt cash payment at this facility.
Insurance Median
$180
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: $250 (281%)
Insurance Median: $180 (202%)
Cash: $250 (281% of Medicare)
Ins. Median: $180 (202% 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 202% of the Medicare baseline (a markup of 102%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $74 - $88 | 83% |
| Aetna | $82 - $385 | 92% |
| Blue Cross Blue Shield | $82 - $385 | 92% |
| Hospice Mount Carmel | $84 | 94% |
| Oscar | $84 | 94% |
| UnitedHealthcare | $84 - $323 | 94% |
| The Health Plan | $86 - $253 | 97% |
| Enterprise Group Planning | $162 | 182% |
| Geha | $173 - $323 | 195% |
| Gravie Admin Services | $173 | 195% |
| Healthez | $173 | 195% |
| Meritain | $173 | 195% |
| Webtpa | $173 | 195% |
| Custom Design Benefits | $175 | 197% |
| Access Health | $180 | 202% |
| Acclaim | $180 | 202% |
| Administrative Concepts | $180 | 202% |
| Allegeant | $180 | 202% |
| Allied Benefit Systems | $180 | 202% |
| American Family | $180 | 202% |
| American Healthcare Alliance | $180 | 202% |
| American National | $180 | 202% |
| American Republic | $180 | 202% |
| Amerihealth | $180 | 202% |
| Aultcare | $180 | 202% |
| Automated Benefit Services | $180 | 202% |
| Auxiant | $180 | 202% |
| Benefit Administrative Systems,Llc | $180 | 202% |
| Boon Chapman | $180 | 202% |
| Cam Administrative Services | $180 | 202% |
| Christian Brother Services | $180 | 202% |
| Christian Brothers Holy Cross | $180 | 202% |
| Claimchoice Adminstrators | $180 | 202% |
| Comprehensive Benefits | $180 | 202% |
| Continental Life Insurance | $180 | 202% |
| Coventry | $180 | 202% |
| Custom Benefit Administrators | $180 | 202% |
| Cypress Benefit Administrators | $180 | 202% |
| Employee Benefit Concepts | $180 | 202% |
| Employee Benefit Management | $180 | 202% |
| Forest County Potawatomi | $180 | 202% |
| Freedom Life Insurance Company | $180 | 202% |
| Group Administrators | $180 | 202% |
| Group Marketing Services | $180 | 202% |
| Group Pension Administrators | $180 | 202% |
| Guardian | $180 | 202% |
| Health America | $180 | 202% |
| Health Choices | $180 | 202% |
| Healthcare Management Admin | $180 | 202% |
| Insight | $180 | 202% |
| Intercare | $180 | 202% |
| Jfp Benefit Management | $180 | 202% |
| Jp Farley Corporation | $180 | 202% |
| Key Benefit Administrator | $180 | 202% |
| Liberty Union Life Assurance Co | $180 | 202% |
| Lucent Health | $180 | 202% |
| Luminare Health | $180 | 202% |
| Magnacare | $180 | 202% |
| Medcost | $180 | 202% |
| Mutual Health Services | $180 | 202% |
| Mutual Of Omaha | $180 | 202% |
| Ncas | $180 | 202% |
| Nippon Life Ins | $180 | 202% |
| Nova | $180 | 202% |
| Painters Union Insurance Fund | $180 | 202% |
| Physicians Mutual | $180 | 202% |
| Plumbers Local 98 Insurance Fund | $180 | 202% |
| Prairie States | $180 | 202% |
| Preferred One | $180 | 202% |
| Primary Physician Care | $180 | 202% |
| Professional Benefit Administrators | $180 | 202% |
| Secureone Preferred United Plans | $180 | 202% |
| Siho Insurance Services | $180 | 202% |
| Sisco Benefits | $180 | 202% |
| The Loomis Company | $180 | 202% |
| Trustmark Small Business Benefits | $180 | 202% |
| U Of M Health Plan | $180 | 202% |
| Unicare | $180 | 202% |
| Unified Group Services | $180 | 202% |
| Us Health And Life | $180 | 202% |
| Valenz | $180 | 202% |
| Varipro | $180 | 202% |
| Wps | $180 | 202% |
| Rural Carrier Health Benefit Plan | $181 | 204% |
| Quality Care Partners | $190 | 214% |
| Medben | $192 - $289 | 216% |
| American Postal Workers Secondary | $196 | 220% |
| Cigna | $196 | 220% |
| Health Partners | $196 | 220% |
| Healthgram | $196 | 220% |
| Mvp | $196 | 220% |
| Priority Health | $196 | 220% |
| Humana | $197 - $385 | 222% |
| First Health | $203 | 228% |
| Consociate | $235 | 264% |
| Health Ohio Network | $235 | 264% |
| Caresource | $281 | 316% |
| Healthlink Inc | $289 | 325% |
| Luminare Health (Detroit) | $289 | 325% |
| Medical Benefits Mutual | $289 | 325% |
| Ohio Health Choice | $289 | 325% |
| Ohio Ppo Connect | $289 | 325% |
| Osu Not Independent Choice | $289 | 325% |
| Medical Mutual | $293 | 330% |
| Ameriben | $308 | 346% |
| Medi Share | $308 | 346% |
| Multiplan | $308 | 346% |
| Ohiohealthy | $308 | 346% |
| Phcs | $308 | 346% |
| Philadelphia American Life Insurance | $308 | 346% |
| Twin Valley Psychiatric | $308 | 346% |
| Blue Benefit Administrators Of Massachusetts | $313 | 352% |
| Blue Care Network | $313 | 352% |
| Blue Distinction Transplant | $313 | 352% |
| Blue Shield - Ca | $313 | 352% |
| Blue Shield - Id (Regence) | $313 | 352% |
| Blue Shield - Ny Highmark Northeastern | $313 | 352% |
| Blue Shield - Ny Highmark Western | $313 | 352% |
| Blue Shield - Pa (Highmark) | $313 | 352% |
| Blue Shield - Wa (Regence) | $313 | 352% |
| Health Smart | $327 | 368% |
| Bccp | $385 | 433% |
| Medicaid / KanCare | $385 | 433% |
| Optima Health | $385 | 433% |
| Crime Victim Assistance | $632 | 711% |
| Ohio Safe Program | $632 | 711% |