CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mercy Hospital Marietta

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $265
Cash Discount Price: $442
vs. Medicare Baseline: 2.98x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mercy Hospital Marietta is $265. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $442. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.98x the Medicare baseline. Located in 300 Wanda Street, Marietta, OK.

Cash / Self-Pay

$442

Average discount available for prompt cash payment at this facility.

Insurance Median

$265

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: $442 (497%)

Insurance Median: $265 (298%)

Cash: $442 (497% of Medicare)

Ins. Median: $265 (298% 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 298% of the Medicare baseline (a markup of 198%). 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
Aetna	$24 - $308	27%
Humana	$24 - $143	27%
Medicaid / KanCare	$24	27%
Blue Cross Blue Shield	$143 - $234	161%
Cross Timbers Hospice [20098]	$143	161%
Elara Caring Aspire Hospice Contracted [320433]	$143	161%
Elara Caring Aspire Hospice [20433]	$143	161%
Halo Hcr Inc Hospice Contracted [320432]	$143	161%
Halo Hcr Inc Hospice [20432]	$143	161%
Independent Health [20197]	$143	161%
Indian Health Service Contracted [320198]	$143	161%
Kindful Hospice Contracted [320434]	$143	161%
Kindful Hospice [20434]	$143	161%
Medical Associates Health [20444]	$143	161%
Medicare (plans)	$143 - $150	161%
Mercy Hospice Okc [20252]	$143	161%
UnitedHealthcare	$150 - $309	169%
Tricare	$151	170%
Cigna	$156 - $332	175%
Webtpa Contracted [320417]	$186	209%
Aither Health Contracted [320449]	$265 - $376	298%
Mercy Benefit Admin Contracted [320251]	$265 - $398	298%
Quik Trip Contracted [320447]	$265	298%
Show-Me Health Administrators Contracted [320483]	$265	298%
Osma Health Contracted [320292]	$309	348%
United Medical Resources Contracted [320454]	$309 - $398	348%
First Health Contracted [320128]	$312	351%
Benefit Management Contracted [320052]	$332 - $398	373%
Healthcare Highways Plus Contracted [320175]	$332	373%
Auxiant Contracted [320462]	$376 - $398	423%
Ebms Contracted [320493]	$376	423%
Healthlink Contracted [320179]	$376 - $398	423%
Preferred Community Choice Contracted [320311]	$376	423%
Federal Medical Center Contracted [320127]	$398	448%
Healthscope Contracted [320182]	$398	448%
Point C Contracted [320238]	$398	448%
Preferred Health Plan Contracted [320522]	$398	448%
Tri State Healthcare Coalition Contracted [320379]	$398	448%

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 $442.
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 Mercy Hospital Marietta 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.