CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Ascension Seton Hays

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $85
Cash Discount Price: $267
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Ascension Seton Hays is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $267. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.96x the Medicare baseline. Located in 6001 Kyle Pkwy, Kyle, TX.

Cash / Self-Pay

$267

Average discount available for prompt cash payment at this facility.

Insurance Median

$85

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: $267 (300%)

Insurance Median: $85 (96%)

Cash: $267 (300% of Medicare)

Ins. Median: $85 (96% 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
Champva	$23 - $32	26%
Ambetter / Centene	$31 - $154	35%
Blue Cross Blue Shield	$31 - $323	35%
Dell Chip/Chip Perinate	$31 - $40	35%
Dell Star	$31	35%
UnitedHealthcare	$31 - $87	35%
Wellpoint Chip/Chip Perinate	$31 - $40	35%
Wellpoint Star	$31	35%
Wellpoint Star Plus	$31 - $40	35%
Wellpoint Star Kids	$40	45%
Humana	$50 - $85	56%
Aarp Mc Wellmed	$84	94%
Sendero Chap	$84	94%
Addr Cancer Together	$85	96%
Aetna	$85 - $274	96%
Covid Hrsa	$85	96%
Cshcn Cidc	$85	96%
Devoted Health Mcr Replacement	$85	96%
Medicare (plans)	$85	96%
Research Study	$85	96%
Smarthealth	$85	96%
Superior Allwell	$85	96%
Tricare	$85 - $97	96%
Utmb	$85	96%
Wellcare Med Advantage	$85	96%
Connected Senior Care	$88	99%
Pphp Mcr Advantage	$90	101%
Tx Independence Hp	$90	101%
Occunet	$119	134%
Sendero Idealcare	$149	168%
Cigna	$194	218%
Superior Star	$202 - $392	227%
Superior Star Foster	$202 - $392	227%
Superior Star Kids	$202 - $392	227%
Superior Star Plus	$202 - $392	227%
Superior Chip/Chip Perinate	$227 - $441	255%
Seton Performance Plus	$251	282%
Covenant Health	$274	308%

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 $267.
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 Ascension Seton Hays 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.