CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Hospital Metropolitano Dr Pila

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $14
Cash Discount Price: $46
vs. Medicare Baseline: 0.16x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Hospital Metropolitano Dr Pila is $14. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.16x the Medicare baseline. Located in 2435 Boulevard Luis A Ferre, Ponce, PR.

Cash / Self-Pay

$46

Average discount available for prompt cash payment at this facility.

Insurance Median

$14

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: $46 (52%)

Insurance Median: $14 (16%)

Cash: $46 (52% of Medicare)

Ins. Median: $14 (16% 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
Acaa	$7	8%
Auxilio Mutuo	$8	9%
First Medical	$9 - $10	10%
Triple S	$9 - $22	10%
Mc	$10	11%
Mso	$10 - $21	11%
Cigna	$11	12%
Humana	$11 - $14	12%
Privado	$11	12%
Mcs	$12 - $30	13%
Plan De Salud Menonita	$12 - $14	13%
Hospicio	$13	15%
Aarp	$14	16%
Prossam	$15	17%
Va	$15	17%
Bl	$16	18%
Fondo Del Seguro Estado	$22	25%
Ch	$26	29%
Salud Correccional	$26	29%
Mapfre	$27	30%
Tricare	$30	34%
Corvel Corporation	$35	39%

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 $46.
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 Hospital Metropolitano Dr Pila 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.