CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $93
Cash Discount Price: $140
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Independence Health System Butler Memorial Hospita is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.05x the Medicare baseline. Located in One Hospital Way, Butler, PA.

Cash / Self-Pay

$140

Average discount available for prompt cash payment at this facility.

Insurance Median

$93

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: $140 (157%)

Insurance Median: $93 (105%)

Cash: $140 (157% of Medicare)

Ins. Median: $93 (105% 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
Upmc	$24 - $210	27%
Medicaid / KanCare	$26	29%
UnitedHealthcare	$26 - $217	29%
Gateway	$28 - $210	31%
Amerihealth	$29 - $89	33%
Geisinger	$29 - $200	33%
Jefferson Health Plan	$29	33%
Aetna	$30 - $195	34%
Highmark	$37 - $179	42%
Highmark - Ind.& Managed Care	$37 - $199	42%
Highmark Aca - Direct Blue	$37 - $112	42%
Highmark Community Blue	$37 - $175	42%
Ellwood Group	$60 - $169	67%
Martin'S Point - Usfhp	$70 - $85	79%
Devoted Health Plan	$80 - $90	90%
Pnoa	$83 - $160	93%
Workers Comp	$84	94%
Life Butler County	$85	96%
Medicare (plans)	$85	96%
Peak Health	$85 - $199	96%
Provider Partners	$85	96%
Tricare	$85	96%
Humana	$88	99%
The Health Plan	$90 - $199	101%
Pa Health & Wellness	$91	102%
American Health Plan	$93	105%
Ccbh - Behavioral Health	$97 - $100	109%
Cigna	$100 - $194	112%
Private Healthcare Systems	$140 - $170	157%
Devon	$150	169%
Intergroup	$160	180%
Multiplan	$180	202%

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 $140.
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 Independence Health System Butler Memorial Hospita 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.