CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mercy Hospital Ada

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $198
  • Cash Discount Price: $278
  • vs. Medicare Baseline: 2.23x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mercy Hospital Ada is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $278. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.23x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.
Cash / Self-Pay
$278

Average discount available for prompt cash payment at this facility.

Insurance Median
$198

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: $278 (313%)
Insurance Median: $198 (223%)
Cash: $278 (313% of Medicare)
Ins. Median: $198 (223% 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 223% of the Medicare baseline (a markup of 123%). 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
Aetna $24 - $321 27%
Humana $24 - $90 27%
Medicaid / KanCare $24 - $121 27%
Blue Cross Blue Shield $88 99%
Cherokee Nation Health Serv Contracted [320066] $88 99%
Cross Timbers Hospice [20098] $88 99%
Dept Of Veteran Affairs Contracted [320106] $88 99%
Elara Caring Aspire Hospice Contracted [320433] $88 99%
Elara Caring Aspire Hospice [20433] $88 99%
Halo Hcr Inc Hospice Contracted [320432] $88 99%
Halo Hcr Inc Hospice [20432] $88 99%
Independent Health [20197] $88 99%
Indian Health Service Contracted [320198] $88 99%
Kindful Hospice Contracted [320434] $88 99%
Kindful Hospice [20434] $88 99%
Medical Associates Health [20444] $88 99%
Medicare (plans) $88 - $427 99%
Mercy Hospice Okc [20252] $88 99%
Provider Partners Health Plans Contracted [320450] $88 99%
Qual Choice Contracted [320325] $88 99%
Tricare $88 99%
UnitedHealthcare $88 - $140 99%
Globalhealth Contracted [320145] $90 101%
Cigna $91 102%
Ambetter / Centene $121 136%
Home State Health Plan Contracted [320187] $121 136%
Novasys Contracted [320285] $121 136%
United Medical Resources Contracted [320454] $140 - $256 157%
Workers Comp [20426] $152 171%
Healthcare Highways Plus Contracted [320175] $167 - $320 188%
Webtpa Contracted [320417] $179 201%
Osma Health Contracted [320292] $192 216%
Health Choice Contracted [320166] $198 223%
Healthsmart Preferred Care Contracted [320184] $198 223%
Kempton Contracted [320214] $198 223%
Medica Contracted [320239] $199 - $427 224%
Benefit Management Contracted [320052] $214 - $278 241%
Aither Health Contracted [320449] $256 288%
Auxiant Contracted [320462] $256 288%
Ebms Contracted [320493] $256 288%
Federal Medical Center Contracted [320127] $256 288%
Healthlink Contracted [320179] $256 288%
Healthscope Contracted [320182] $256 288%
Imagine 360 Contracted [320494] $256 288%
Mercy Benefit Admin Contracted [320251] $256 - $278 288%
Point C Contracted [320238] $256 288%
Preferred Health Plan Contracted [320522] $256 288%
Quik Trip Contracted [320447] $256 288%
Reflect Health Contracted [320492] $256 288%
Show-Me Health Administrators Contracted [320483] $256 288%
Yuzu Health Contracted [320521] $256 288%
Globalhealth Contracted [320144] $269 303%
First Health Contracted [320128] $355 399%
Multiplan Contracted [320270] $363 408%
Private Health Care Systems Contracted [320320] $363 408%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 430 North Monte Vista, Ada, OK 74820
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals