CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Froedtert Memorial Lutheran Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $473
  • Cash Discount Price: $400
  • vs. Medicare Baseline: 5.32x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Froedtert Memorial Lutheran Hospital is $473. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $400. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.32x the Medicare baseline. Located in 9200 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$400

Average discount available for prompt cash payment at this facility.

Insurance Median
$473

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: $400 (450%)
Insurance Median: $473 (532%)
Cash: $400 (450% of Medicare)
Ins. Median: $473 (532% 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 532% of the Medicare baseline (a markup of 432%). 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 $89 - $619 100%
Community Care $89 100%
Health Partners $89 - $451 100%
Humana $89 100%
Icare $89 100%
Molina $89 100%
Network Health Plan $89 - $399 100%
Priority Health $89 100%
Quartz $89 100%
Security Health Plan $89 - $572 100%
UnitedHealthcare $89 - $617 100%
Upper Peninsula Health Plan $89 100%
Aetna $91 - $473 102%
Wellcare $91 102%
Care Wisconsin/Mychoice $92 103%
Centivo $209 - $240 235%
Medical College Of Wisconsin $230 - $240 259%
Chorus Community Health Plan $271 - $284 305%
Froedtert South $278 - $291 313%
Wisconsin Physician Services Statewide Alliance $438 - $459 493%
Sheboygan Employers Health Network $445 501%
Trilogy $452 - $473 508%
Health Payment Systems $458 - $479 515%
Cigna $543 - $568 611%
Dean Health Plan $557 - $582 626%
Group Health Cooperative $557 - $582 626%
Healtheos $557 - $582 626%
Multiplan/Private Healthcare Systems $557 - $582 626%
Healthsmart $578 - $604 650%
Wisconsin Physician Services $592 - $619 666%
First Health Network $602 - $630 677%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9200 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals