CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $89
Cash Discount Price: $611
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Nationwide Children's Hospital Toledo, LLC is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $611. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.00x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$611

Average discount available for prompt cash payment at this facility.

Insurance Median

$89

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: $611 (687%)

Insurance Median: $89 (100%)

Cash: $611 (687% of Medicare)

Ins. Median: $89 (100% 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
Caresource	$10 - $93	11%
Paramount	$10	11%
Blue Cross Blue Shield	$11 - $519	12%
Front Path Health Coalition	$13 - $458	15%
Mcclaren Health Plan	$14 - $458	16%
Aetna	$18 - $392	20%
UnitedHealthcare	$25 - $514	28%
Cigna	$33 - $107	37%
Ohc	$47 - $509	53%
Ohio Ppo Connect	$47 - $509	53%
Molina	$64 - $106	72%
Amerihealth	$65	73%
Bchp	$65	73%
Humana	$65	73%
Mcclaren Health Plan - Michigan	$92	103%
Mmo	$254 - $356	286%
First Health	$784	882%

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 $611.
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 Nationwide Children's Hospital Toledo, LLC 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.