CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Uva Health Culpeper Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $197
Cash Discount Price: $319
vs. Medicare Baseline: 2.22x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Uva Health Culpeper Medical Center is $197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $319. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.22x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.

Cash / Self-Pay

$319

Average discount available for prompt cash payment at this facility.

Insurance Median

$197

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: $319 (359%)

Insurance Median: $197 (222%)

Cash: $319 (359% of Medicare)

Ins. Median: $197 (222% 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 222% of the Medicare baseline (a markup of 122%). 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
Tricare	$29	33%
Champva [50002]	$29	33%
Aetna	$72 - $528	81%
Blue Ridge Pace [10510]	$79	89%
Medicaid / KanCare	$79	89%
Humana	$87 - $92	98%
Cigna	$87 - $426	98%
Blue Cross Blue Shield	$87 - $261	98%
Carefirst [30007]	$87 - $106	98%
HMO Part B [10099]	$87	98%
VA Ccn [99926]	$87 - $90	98%
VA Ccn [99927]	$87 - $90	98%
UnitedHealthcare	$87 - $640	98%
Medicare (plans)	$87 - $90	98%
Veterans Administration [99910]	$90	101%
Sentara [40021]	$123 - $495	138%
Sentara Behavioral Health [40052]	$125 - $495	141%
Beacon Health Options [40012]	$300	337%
Commercial Contracted Hb Only [40056]	$315	354%
Commercial Generic [40000]	$315 - $420	354%
Geha [40009]	$349 - $517	393%
Commercial Contracted Tpa [40055]	$360 - $420	405%
Umwa [40037]	$420	472%
Healthsmart [40013]	$450	506%
Vhn Generic [40040]	$484 - $510	544%
Multiplan Generic [40035]	$484 - $510	544%
First Health Generic [40033]	$492	553%
Gateway Health Alliance [40034]	$510	574%
Onenet Workers Comp Generic [60010]	$526	592%
Kaiser Permenente [40014]	$573	644%

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 $319.
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 Uva Health Culpeper Medical Center 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.