CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Prisma Health Tuomey Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $102
  • Cash Discount Price: $377
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Prisma Health Tuomey Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $377. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.15x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$377

Average discount available for prompt cash payment at this facility.

Insurance Median
$102

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: $377 (424%)
Insurance Median: $102 (115%)
Cash: $377 (424% of Medicare)
Ins. Median: $102 (115% 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.

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
Medicaid / KanCare $39 - $89 44%
Humana $42 - $435 47%
Blue Cross Blue Shield $59 - $266 66%
Bluechoice [810] $59 - $265 66%
Scdc-Sc Dept Of Corrections [7232] $64 72%
Cigna $81 - $443 91%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $81 91%
Medicare (plans) $81 - $85 91%
Triwest Healthcare Alliance Vcp [902] $81 91%
Va Community Care Network-Vaccn [903] $81 91%
Tricare $82 92%
UnitedHealthcare $84 - $195 94%
Aetna $85 - $458 96%
Healthy Conn Prime-First Choice Vip Care [5300] $85 96%
Healthy Conn Prime-Molina Healthcare [5330] $85 96%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $85 96%
Workers Comp [600] $114 128%
Prisma Health Seniorcare Pace - Midlands [5400] $135 152%
Prisma Health Seniorcare Pace-Upstate [5200] $135 152%
Ambetter / Centene $150 169%
Golden Rule Insurance Company [2991] $195 219%
Oxford Health Plans [2992] $195 219%
Zzumr-Salt Lake City Ut [3169] $195 219%
Promise Health Plan Contracted [2401] $203 - $348 228%
Orangeburg Senior Helping Center Pace [5401] $232 261%
Bob Jones Univ-Pai [821] $257 289%
Planned Administrators [820] $266 299%
Meritain Health Contracted [2200] $371 - $458 417%
Preferred Administrators Contracted [2839] $406 457%
Medcost [2940] $429 - $481 483%
Atlantic Packaging Contracted [4833] $435 489%
Aps Healthcare System [2981] $464 522%
Multiplan/Phcs Contracted [2950] $516 580%
Vsp Vision Care [2986] $522 587%
First Health Contracted [2952] $539 606%
Furman Int/Allen University Student [2951] $539 606%
Quiktrip-First Health [3067] $539 606%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals