CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $300
Cash Discount Price: $350
vs. Medicare Baseline: 3.37x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Baylor Scott & White Medical Center - Marble Falls is $300. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $350. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.37x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

$350

Average discount available for prompt cash payment at this facility.

Insurance Median

$300

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: $350 (394%)

Insurance Median: $300 (337%)

Cash: $350 (394% of Medicare)

Ins. Median: $300 (337% 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 337% of the Medicare baseline (a markup of 237%). 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
Superior Health Plan	$40 - $80	45%
Baylor Scott & White Health Plan	$76 - $250	85%
Humana	$80 - $409	90%
Triwest	$80	90%
American Health Plan	$84	94%
Blue Cross Blue Shield	$84 - $306	94%
Corvel	$84	94%
Healthspring	$84	94%
Prime Health Services	$84	94%
Procare Advantage	$84	94%
UnitedHealthcare	$92 - $323	103%
Sedgwick	$120	135%
Cigna	$300 - $352	337%
Aetna	$321	361%
Midcoast	$321	361%
Quiktrip	$321	361%
University Of Mary Hardin-Baylor	$339	381%
Independent Medical System	$350	394%
Curative	$380	427%
First Health	$409	460%
Healthsmart	$409 - $438	460%
Bluebell Creameries	$438	493%
Private Health Care System	$438	493%
Three Rivers	$526	592%

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 $350.
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 Baylor Scott & White Medical Center - Marble Falls 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.