CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Sycamore Shoals Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $80
Cash Discount Price: $69
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Sycamore Shoals Hospital is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.90x the Medicare baseline. Located in 1501 West Elk Avenue, Elizabethton, TN.

Cash / Self-Pay

$69

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $69 (78%)

Insurance Median: $80 (90%)

Cash: $69 (78% of Medicare)

Ins. Median: $80 (90% 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
Blue Cross Blue Shield	$20 - $103	22%
UnitedHealthcare	$40 - $462	45%
Cigna	$54 - $83	61%
Amerigroup	$57 - $79	64%
Optima Health	$77	87%
Aetna	$79 - $295	89%
Humana	$79	89%
Managed Medicaire	$79	89%
Medicare (plans)	$79	89%
Sentara Health	$79 - $129	89%
United Mine Workers Of America	$79	89%
Molina Healthcare	$80 - $82	90%
Devoted Health Plan	$83	93%
Nhc Advantage	$83	93%
Wellcare	$84 - $462	94%
Medcost	$162	182%
Ambetter / Centene	$172	193%
First Health Coventry	$346	389%
Seven Corners, Inc.	$462	520%

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 $69.
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 Sycamore Shoals Hospital 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.