CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Texas Childrens Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $529
  • Cash Discount Price: $553
  • vs. Medicare Baseline: 5.95x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Texas Childrens Hospital is $529. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $553. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.95x the Medicare baseline. Located in 6621 Fannin Street, Houston, TX.
Cash / Self-Pay
$553

Average discount available for prompt cash payment at this facility.

Insurance Median
$529

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: $553 (622%)
Insurance Median: $529 (595%)
Cash: $553 (622% of Medicare)
Ins. Median: $529 (595% 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 595% of the Medicare baseline (a markup of 495%). 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
Superior Chip $40 - $42 45%
Driscoll Children'S Health Plan Mcd $44 49%
First Care Health Plan $223 - $529 251%
UnitedHealthcare $223 - $529 251%
Molina Mcd $248 279%
Blue Cross Blue Shield $289 - $520 325%
Community Health Choice $292 - $529 328%
Community First Health Plan Mcd $330 371%
Cook Children'S Health Plan $330 371%
Cigna $471 - $529 530%
Aetna $529 595%
Kelseycare $537 604%
Healthsmart $578 650%
Evolutions Healthcare $620 697%
First Health $727 - $785 818%
Multiplan $743 836%
Galaxy Health Network $785 883%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6621 Fannin Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens