CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Carilion Giles Community Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $545
  • Cash Discount Price: $375
  • vs. Medicare Baseline: 6.13x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Carilion Giles Community Hospital is $545. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $375. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.13x the Medicare baseline. Located in 159 Hartley Way, Pearisburg, VA.
Cash / Self-Pay
$375

Average discount available for prompt cash payment at this facility.

Insurance Median
$545

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: $375 (422%)
Insurance Median: $545 (613%)
Cash: $375 (422% of Medicare)
Ins. Median: $545 (613% 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 613% of the Medicare baseline (a markup of 513%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 - $449 40%
Sentara Health Plan $36 - $664 40%
Abh Of Va (Formerly Coventry) $37 42%
Abh Of Wva (Formerly Coventry) $37 42%
Humana $37 - $83 42%
UnitedHealthcare $37 - $875 42%
Aetna $76 - $711 85%
Gateway - Tier 3 $589 662%
Vhn - Ultra $664 747%
Cigna $722 - $771 812%
Connecticare $750 844%
Vhn - Plus $825 928%
Gateway - Tier 2 $857 964%
Vhn $857 964%
Vhn - Link $964 1084%
Gateway - Tier 1 $1,017 1144%
Vhn - Secondary Payors $1,017 1144%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 159 Hartley Way, Pearisburg, VA 24134
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals