CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Stafford Hospital, LLC

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $95
Cash Discount Price: $157
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Stafford Hospital, LLC is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $157. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.07x the Medicare baseline. Located in 101 Hospital Center Boulevard, Stafford, VA.

Cash / Self-Pay

$157

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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: $157 (177%)

Insurance Median: $95 (107%)

Cash: $157 (177% of Medicare)

Ins. Median: $95 (107% 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
Innovation	$63 - $69	71%
Aetna	$77 - $288	87%
Blue Cross Blue Shield	$77 - $196	87%
Humana	$77 - $87	87%
Sentara	$77 - $213	87%
UnitedHealthcare	$77 - $100	87%
Molina	$80 - $90	90%
Kaiser	$82 - $93	92%
Cf	$97 - $106	109%
Cigna	$163 - $204	183%
Medcost	$282	317%
PHCS	$288	324%

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 $157.
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 Stafford Hospital, LLC 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.