CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Colleton Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $556
Cash Discount Price: $977
vs. Medicare Baseline: 6.25x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Colleton Medical Center is $556. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $977. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.25x the Medicare baseline. Located in 501 Robertson Boulevard, Walterboro, SC.

Cash / Self-Pay

$977

Average discount available for prompt cash payment at this facility.

Insurance Median

$556

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: $977 (1099%)

Insurance Median: $556 (625%)

Cash: $977 (1099% of Medicare)

Ins. Median: $556 (625% 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 625% of the Medicare baseline (a markup of 525%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Choice	$39	44%
United	$39 - $560	44%
Select Health	$50	56%
Sc State Employees	$64 - $71	72%
Absolute Total Care	$143 - $190	161%
Blue Choice Health Plan	$146 - $153	164%
Blue Cross Blue Shield	$146 - $1,001	164%
Nhc Advantage	$186 - $200	209%
Pruitt Health	$186 - $200	209%
Employers Health Network	$440 - $474	495%
Value Option	$489 - $527	550%
Vocational Rehab	$528 - $569	594%
Medcost	$552 - $769	621%
Aetna	$566 - $610	637%
Cigna	$632 - $681	711%
Humana	$636 - $949	715%
Mhnet	$734 - $790	826%
Evernorth	$782 - $843	880%
Multiplan	$831 - $896	935%
North American Administrators	$831 - $896	935%
Prime Health	$831 - $896	935%
First Health	$880 - $949	990%
Novanet	$880 - $949	990%

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 $977.
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 Colleton Medical Center 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.