CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: St David's South Austin Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $468
  • Cash Discount Price: $1,093
  • vs. Medicare Baseline: 5.26x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at St David's South Austin Medical Center is $468. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,093. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.26x the Medicare baseline. Located in 901 West Ben White Blvd, Austin, TX.
Cash / Self-Pay
$1,093

Average discount available for prompt cash payment at this facility.

Insurance Median
$468

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: $1,093 (1229%)
Insurance Median: $468 (526%)
Cash: $1,093 (1229% of Medicare)
Ins. Median: $468 (526% 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 526% of the Medicare baseline (a markup of 426%). 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
Amerigroup $26 29%
St David’S Hospice $40 45%
United $41 - $752 46%
Blue Cross Blue Shield $42 - $533 47%
Molina Healthcare $44 49%
Aetna $50 - $274 56%
Humana $50 56%
Sendero $50 56%
Superior Health Plan $50 - $284 56%
Cigna $107 - $485 120%
Moda $237 - $393 267%
Covenant Management Systems $291 - $481 327%
Healthcare Highways $294 - $501 331%
Imo Med - Select Network $303 - $501 341%
Nomi Health $323 - $618 363%
Moda Health $364 - $618 409%
Evry Health $372 - $615 418%
Texas Healthcare Foundation Heb $374 - $618 421%
Texas Workforce Commission $394 - $652 443%
Curative Administrators $404 - $668 454%
Harbor Health Team $404 - $668 454%
Averde Health $454 - $752 511%
Comanche County $505 - $836 568%
Emerging Therapy Solutions $505 - $1,153 568%
National Choicecare $505 - $836 568%
Healthsmart Preferred Care $556 - $1,337 625%
Independent Medical Systems $556 - $919 625%
Physicians Cooperative Of Texas $556 - $919 625%
Prime Health $606 - $1,003 682%
First Health $636 - $1,201 715%
Coastal Comp Health Networks $656 - $1,086 738%
National Health Care $656 - $1,086 738%
Occunet $707 - $1,170 795%
Texas Municipal League $707 - $1,170 795%
Medcorp Southwest $758 - $1,253 853%
Preferred Health Arrangement $758 - $1,253 853%
Rockport Healthcare Group $808 - $1,504 909%
Bce Emergis Corporation $909 - $1,504 1022%
Beech Street $909 - $1,504 1022%
Medical Control Network Solutions $909 - $1,504 1022%
Multiplan $909 - $1,504 1022%
UnitedHealthcare $1,010 - $1,671 1136%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 West Ben White Blvd, Austin, TX 78704
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals