CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Washington Hospital, The

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $108
Cash Discount Price: $207
vs. Medicare Baseline: 1.21x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Washington Hospital, The is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $207. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.21x the Medicare baseline. Located in 155 Wilson Avenue, Washington, PA.

Cash / Self-Pay

$207

Average discount available for prompt cash payment at this facility.

Insurance Median

$108

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: $207 (233%)

Insurance Median: $108 (121%)

Cash: $207 (233% of Medicare)

Ins. Median: $108 (121% 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
Amerihealth Caritas	$30	34%
Highmark Wholecare (Prev Gateway)	$30 - $88	34%
Aetna	$32 - $180	36%
Upmc Health Plan	$63 - $108	71%
Blue Cross Blue Shield	$78 - $194	88%
Senior Life	$84	94%
Humana	$85	96%
Health Plan Of Upper Ohio Valley	$86 - $216	97%
City Of Washington	$168	189%
Cigna	$176	198%
Peak Health	$223	251%
Coventry/First Health	$229	258%

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 $207.
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 Washington Hospital, The 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.