CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Sanford Chamberlain Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $405
Cash Discount Price: $437
vs. Medicare Baseline: 4.56x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Sanford Chamberlain Medical Center is $405. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $437. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.56x the Medicare baseline. Located in 300 S Byron, Chamberlain, SD.

Cash / Self-Pay

$437

Average discount available for prompt cash payment at this facility.

Insurance Median

$405

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: $437 (492%)

Insurance Median: $405 (456%)

Cash: $437 (492% of Medicare)

Ins. Median: $405 (456% 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 456% of the Medicare baseline (a markup of 356%). 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
Sanford Health Plan Align	$187	210%
Ucare	$200 - $480	225%
Wellmark Sd	$200 - $475	225%
Aetna	$203 - $474	228%
Health Partners	$203 - $410	228%
Medicare (plans)	$203	228%
UnitedHealthcare	$203 - $456	228%
Primewest	$206	232%
Sanford Health Plan	$299 - $401	336%
Security Health Plan	$300	337%
Medica	$450 - $482	506%
First Choice Health Network	$491	552%
Healthez	$491	552%
Multiplan	$491	552%

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 $437.
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 Sanford Chamberlain 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.