CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Unitypoint Health - Meriter

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $74
Cash Discount Price: $250
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Unitypoint Health - Meriter is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $250. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.83x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

$250

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $250 (281%)

Insurance Median: $74 (83%)

Cash: $250 (281% of Medicare)

Ins. Median: $74 (83% 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
Aspirus	$10 - $451	11%
Blue Cross Blue Shield	$10 - $714	11%
Illinicare	$10 - $85	11%
Prevea 360	$10 - $639	11%
UnitedHealthcare	$10 - $310	11%
Humana	$11 - $85	12%
Meridiancare	$11 - $85	12%
Health Partners Open Network	$22 - $274	25%
Wellmark Uph Self-Funded	$24 - $434	27%
Cigna	$28 - $225	31%
Security Health Plan	$30 - $233	34%
Medical Associates Health Plan	$33 - $270	37%
Mercy Care	$35 - $249	39%
Quartz	$234	263%

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 $250.
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 Unitypoint Health - Meriter 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.