CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Carilion Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $294
Cash Discount Price: $199
vs. Medicare Baseline: 3.31x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Carilion Medical Center is $294. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $199. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.31x the Medicare baseline. Located in 1906 Belleview Avenue, Se, Roanoke, VA.

Cash / Self-Pay

$199

Average discount available for prompt cash payment at this facility.

Insurance Median

$294

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: $199 (224%)

Insurance Median: $294 (331%)

Cash: $199 (224% of Medicare)

Ins. Median: $294 (331% 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 331% of the Medicare baseline (a markup of 231%). 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
Blue Cross Blue Shield	$36 - $317	40%
Sentara Health Plan	$36 - $352	40%
Abh Of Va (Formerly Coventry)	$37	42%
Abh Of Wva (Formerly Coventry)	$37	42%
Humana	$37 - $83	42%
UnitedHealthcare	$37 - $464	42%
Aetna	$76 - $377	85%
Gateway - Tier 3	$312	351%
Vhn - Ultra	$352	396%
Cigna	$383 - $409	431%
Connecticare	$398	448%
Vhn - Plus	$437	492%
Gateway - Tier 2	$454	511%
Vhn	$454	511%
Vhn - Link	$511	575%
Gateway - Tier 1	$540	607%
Vhn - Secondary Payors	$540	607%

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 $199.
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 Carilion 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.