CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Hillcrest Hospital Pryor

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $417
Cash Discount Price: $234
vs. Medicare Baseline: 4.69x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Hillcrest Hospital Pryor is $417. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $234. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.69x the Medicare baseline. Located in 111 North Bailey Street, Pryor, OK.

Cash / Self-Pay

$234

Average discount available for prompt cash payment at this facility.

Insurance Median

$417

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: $234 (263%)

Insurance Median: $417 (469%)

Cash: $234 (263% of Medicare)

Ins. Median: $417 (469% 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 469% of the Medicare baseline (a markup of 369%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Black Lung [6055]	$195	219%
Healthcare Highways [2210]	$195 - $506	219%
Hooray Health [8000]	$195	219%
Lucent Health [6000]	$195	219%
Oncology Patient Assistance Programs [2295]	$195	219%
Oscar Insurance Company [7005]	$195	219%
Osma Health Network [2345]	$195	219%
Healthscope Benefits [2290]	$238	268%
UnitedHealthcare	$238	268%
Aetna	$342	385%
Allied Benefit Systems Inc [1030]	$342	385%
Coresource [1315]	$342	385%
Coventry Healthcare [1320]	$342	385%
Meritain Health [1655]	$342	385%
The Kempton Group Administrators [2905]	$351	395%
Beacon Health Options Behavioral Health [2890]	$483	543%
Global Health [1430]	$483	543%
Resource One Administrators [2815]	$506	569%
Universal Fidelity [2085]	$506	569%
Web Tpa [2115]	$506	569%
First Health [1375]	$575	647%
Medica [2910]	$575	647%
Multiplan [1680]	$575	647%
Cigna	$641	721%
Healthpartners [1500]	$641	721%
Pba [1775]	$641	721%
Pending Ssi [1616]	$779	876%

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 $234.
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 Hillcrest Hospital Pryor 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.