CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Adventist Health Portland

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $215
  • Cash Discount Price: $164
  • vs. Medicare Baseline: 2.42x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Adventist Health Portland is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.42x the Medicare baseline. Located in 10123 Se Market Street, Portland, OR.
Cash / Self-Pay
$164

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

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: $164 (184%)
Insurance Median: $215 (242%)
Cash: $164 (184% of Medicare)
Ins. Median: $215 (242% 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 242% of the Medicare baseline (a markup of 142%). 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
Pacific Source Comm - All Plans $31 35%
Ods - All Plans $77 87%
Care Oregon - All Plans $82 92%
Kaiser Mcr Adv $97 109%
Humana $99 - $103 111%
Moda Mcr Adv $103 116%
UnitedHealthcare $103 - $307 116%
Healthnet Mcr Adv $111 125%
Providence Hp - All Plans $112 126%
Healthcare Resources - All Plans $115 129%
Regence Preferred Mcr Adv $118 133%
Regence Mcr Adv $149 168%
Ah Employee Health Plan - All Plans $174 196%
Workers Comp $177 199%
Moda Conn Oebb/Syn Pebb $193 217%
Regence Ohsu Plus $193 217%
Regence - All Other Plans $215 242%
Moda Affinity - All Other Plans $222 250%
Cigna $226 254%
Kaiser - All Other Plans $252 283%
Bc Premera First - All Plans $256 288%
Moda Select $303 341%
Worldventure - All Plans $307 345%
Moda Connexus $342 385%
First Choice - All Plans $354 398%
Moda Synergy $362 407%
Multiplan - All Plans $383 431%
Phcs - All Plans $383 431%
Aetna $400 450%
First Health-Coventry - All Plans $409 460%
National Provider Network - All Plans $450 506%
Health Payors Organization Ltd- All Plans $460 517%
Moda Ohsu Ppo/Epo/Hmc $920 1035%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10123 Se Market Street, Portland, OR 97216
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals