CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Highland District Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $96
Cash Discount Price: $230
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Highland District Hospital is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $230. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.08x the Medicare baseline. Located in 1275 North High Street, Hillsboro, OH.

Cash / Self-Pay

$230

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

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: $230 (259%)

Insurance Median: $96 (108%)

Cash: $230 (259% of Medicare)

Ins. Median: $96 (108% 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
Highland_County_Sheriff_Dept	$35	39%
Medicaid / KanCare	$35 - $37	39%
Blue Cross Blue Shield	$36 - $219	40%
Humana	$36 - $255	40%
Medicare (plans)	$92 - $95	103%
UnitedHealthcare	$92	103%
Aetna	$94 - $234	106%
Medigold	$97	109%
Immergrun_Amish	$230	259%
Medben	$230	259%
Central_Benefits_Commercial	$259	291%
Cigna	$259	291%
Medical_Mutual_Commercial	$262	295%
Uhc_	$265	298%

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 $230.
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 Highland District 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.