CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Cook Childrens Medical Center Prosper

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $417
Cash Discount Price: $588
vs. Medicare Baseline: 4.69x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Cook Childrens Medical Center Prosper is $417. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $588. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.69x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$588

Average discount available for prompt cash payment at this facility.

Insurance Median

$417

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: $588 (661%)

Insurance Median: $417 (469%)

Cash: $588 (661% of Medicare)

Ins. Median: $417 (469% 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 469% of the Medicare baseline (a markup of 369%). 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
Aetna	$35 - $757	39%
Beacon	$109 - $481	123%
El Paso Health First	$109 - $481	123%
Health Plan W. Uhrip	$109	123%
Health Plan W/O Uhrip	$109 - $481	123%
Tx Children Health	$109 - $481	123%
Wellpoint	$115	129%
Blue Cross Blue Shield	$118 - $802	133%
Superior Health	$118	133%
Firstcare	$120 - $713	135%
United Community	$120 - $330	135%
UnitedHealthcare	$211 - $757	237%
S&W Health	$402 - $748	452%
Cigna	$407 - $757	458%
Healthscope	$407 - $757	458%
Imagine Health	$407 - $757	458%
Humana	$417 - $784	469%
Multiplan	$417 - $775	469%
First Health	$422 - $784	475%
Galaxy Health	$431 - $802	485%
Healthsmart	$431 - $802	485%
Usamco	$441 - $820	496%

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 $588.
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 Cook Childrens Medical Center Prosper 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.