CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Texas Health Presbyterian Hospital Plano

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $309
Cash Discount Price: $365
vs. Medicare Baseline: 3.48x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Texas Health Presbyterian Hospital Plano is $309. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $365. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.48x the Medicare baseline. Located in 6200 W Parker Rd, Plano, TX.

Cash / Self-Pay

$365

Average discount available for prompt cash payment at this facility.

Insurance Median

$309

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: $365 (411%)

Insurance Median: $309 (348%)

Cash: $365 (411% of Medicare)

Ins. Median: $309 (348% 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 348% of the Medicare baseline (a markup of 248%). 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
Amerigroup	$40 - $92	45%
Blue Cross Blue Shield	$40 - $630	45%
Parkland	$40	45%
UnitedHealthcare	$40 - $722	45%
Superior Wellcare	$42 - $96	47%
Molina	$43 - $92	48%
American Health	$87	98%
Healthspring	$89	100%
Humana	$91	102%
Aetna	$250 - $426	281%
Fort Worth Firefighters	$267 - $371	300%
City Of Fort Worth	$286	322%
Cigna	$336 - $572	378%
Quick Trip	$365 - $383	411%
Phcs	$423 - $453	476%
Healthsmart	$456 - $511	513%
Multiplan	$529	595%
Galaxy	$535	602%
Usa	$535	602%

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 $365.
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 Texas Health Presbyterian Hospital Plano 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.