CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Hospital Metropolitano Dr Susoni

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $15
Cash Discount Price: $78
vs. Medicare Baseline: 0.17x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Hospital Metropolitano Dr Susoni is $15. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $78. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.17x the Medicare baseline. Located in Calle Palma Num 55, Arecibo, PR.

Cash / Self-Pay

$78

Average discount available for prompt cash payment at this facility.

Insurance Median

$15

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: $78 (88%)

Insurance Median: $15 (17%)

Cash: $78 (88% of Medicare)

Ins. Median: $15 (17% 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%
First Medical	$10	11%
Hospicio	$10	11%
Mc	$10	11%
Cigna	$11	12%
Fondo Del Seguro Estado	$12	13%
Mcs	$12 - $17	13%
Plan De Salud Menonita	$12	13%
Prossam	$13	15%
Aarp	$14	16%
Humana	$14 - $26	16%
Tricare	$15	17%
Triple S	$16 - $22	18%
Ch	$17	19%
Comerciales	$17	19%
Va	$17	19%
Aetna	$19	21%
Mso	$26	29%
Mapfre	$27	30%
Bl	$32	36%

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 $78.
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 Susoni 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.