CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Leconte Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $90
Cash Discount Price: $59
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Leconte Medical Center is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $59. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.01x the Medicare baseline. Located in 742 Middlecreek Road, Sevierville, TN.

Cash / Self-Pay

$59

Average discount available for prompt cash payment at this facility.

Insurance Median

$90

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: $59 (66%)

Insurance Median: $90 (101%)

Cash: $59 (66% of Medicare)

Ins. Median: $90 (101% 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
UnitedHealthcare	$28 - $164	31%
Blue Cross Blue Shield	$29 - $134	33%
Aetna	$39 - $90	44%
Cigna	$58 - $90	65%
Ambetter / Centene	$65	73%
Wellpoint	$76 - $90	85%
Farm Bureau	$85	96%
Ehn	$86	97%
Tricare	$86	97%
Humana	$89	100%
Devoted Health	$90	101%
Wellcare	$90	101%
Correctional Medical Services	$115	129%
Community Services Network	$124	139%
Usa Managed Care Organization	$134	151%
Novanet	$143	161%
Direct Care America	$153	172%
Medsave Usa	$153	172%
National Provider Network	$153	172%
Beech Street	$162	182%
Ccn Managed Care	$162	182%
Initial Group	$168	189%
Galaxy Health Network	$172	193%

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 $59.
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 Leconte 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.