CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Tristar Summit Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $148
Cash Discount Price: $1,013
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Tristar Summit Medical Center is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,013. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.66x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.

Cash / Self-Pay

$1,013

Average discount available for prompt cash payment at this facility.

Insurance Median

$148

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: $1,013 (1139%)

Insurance Median: $148 (166%)

Cash: $1,013 (1139% of Medicare)

Ins. Median: $148 (166% 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	$22 - $46	25%
Humana	$42 - $658	47%
Aetna	$53 - $506	60%
United	$84 - $456	94%
Cigna	$92 - $810	103%
Kentucky Labor Cabinet	$186	209%
Apex Health	$192	216%
Nhc Advantage, Inc.	$192	216%
Pruitt Health (Allyalign)	$192	216%
Centurion	$417	469%
Bgfh Singlesource	$506 - $861	569%
Multiplan	$658	740%
Employers Health Network	$709	797%
Odom'S Tn Pride Sausage	$760	855%
Compsych	$810	911%
Beech Street	$891	1002%
Prime Health	$891	1002%

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 $1,013.
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 Tristar Summit 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.