CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Marshfield Medical Center - Beaver Dam (Mmc-Bd)

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $280
Cash Discount Price: $383
vs. Medicare Baseline: 3.15x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Marshfield Medical Center - Beaver Dam (Mmc-Bd) is $280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $383. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.15x the Medicare baseline. Located in 707 S University Ave, Beaver Dam, WI.

Cash / Self-Pay

$383

Average discount available for prompt cash payment at this facility.

Insurance Median

$280

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: $383 (431%)

Insurance Median: $280 (315%)

Cash: $383 (431% of Medicare)

Ins. Median: $280 (315% 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 315% of the Medicare baseline (a markup of 215%). 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
Humana	$84 - $359	94%
Managed Health Services	$84	94%
Molina Healthcare Of Wi	$84 - $343	94%
Network Health Plan	$84 - $336	94%
Quartz	$84 - $230	94%
Security Health Plan (Shp)	$84 - $233	94%
UnitedHealthcare	$84 - $478	94%
Veteran'S Administration (Va Ccn)	$84	94%
Blue Cross Blue Shield	$86 - $276	97%
Group Health Cooperative Of Eau Claire	$89 - $383	100%
Icare	$90	101%
Wps Health Insurance	$135 - $271	152%
The Alliance	$205	231%
Amish/Mennonite	$222	250%
Cigna	$274 - $298	308%
Health Payment Systems	$280	315%
First Health	$343	386%
Trilogy	$363	408%
Healtheos By Multiplan Inc.	$375 - $383	422%
Health Partners	$383	431%
Coventry	$387	435%

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 $383.
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 Marshfield Medical Center - Beaver Dam (Mmc-Bd) 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.