CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Sanford Usd Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $229
  • Cash Discount Price: $506
  • vs. Medicare Baseline: 2.58x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Sanford Usd Medical Center is $229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $506. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.58x the Medicare baseline. Located in 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD.
Cash / Self-Pay
$506

Average discount available for prompt cash payment at this facility.

Insurance Median
$229

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: $506 (569%)
Insurance Median: $229 (258%)
Cash: $506 (569% of Medicare)
Ins. Median: $229 (258% 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 258% of the Medicare baseline (a markup of 158%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $40 - $114 45%
Sanford Health Plan $40 45%
Sanford Health Plan Align $84 94%
Ucare $90 - $444 101%
Aetna $91 - $483 102%
Health Partners $91 - $246 102%
Medicare (plans) $91 102%
UnitedHealthcare $91 - $557 102%
Primewest $92 - $95 103%
Security Health Plan $348 391%
Medica $426 - $456 479%
First Choice Health Network $569 640%
Healthez $569 640%
Multiplan $569 640%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 W 18Th St Post Office Box 5039, Sioux Falls, SD 57117
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals