CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Black River Memorial Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $198
Cash Discount Price: $365
vs. Medicare Baseline: 2.23x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Black River Memorial Hospital is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $365. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.23x the Medicare baseline. Located in 711 W Adams St, Black River Falls, WI.

Cash / Self-Pay

$365

Average discount available for prompt cash payment at this facility.

Insurance Median

$198

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: $365 (411%)

Insurance Median: $198 (223%)

Cash: $365 (411% of Medicare)

Ins. Median: $198 (223% 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 223% of the Medicare baseline (a markup of 123%). 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
Blue Cross Blue Shield	$8 - $356	9%
My Choice Wisconsin, Inc.	$8 - $207	9%
Quartz Health Solutions, Inc	$8 - $369	9%
Security Health Plan	$8 - $378	9%
The Alliance	$8 - $389	9%
UnitedHealthcare	$8 - $382	9%
Group Health Cooperative Of Eau Claire	$10 - $393	11%
Humana	$10 - $377	11%
Multiplan	$23 - $401	26%
Corvel	$124 - $247	139%
Triology Health Solutions	$184 - $385	207%
Medica	$191 - $378	215%
Association Benefits Solution	$194 - $385	218%
Family Health Center Of Marshfield	$194 - $385	218%
First Health Group Corporation	$194 - $385	218%
Provider Network Of America	$194 - $385	218%
Cigna	$198 - $393	223%
Cofinity	$198 - $393	223%
Coventry Health Care	$198 - $393	223%
Custom Benefit Administrators	$198 - $393	223%
Healthpartners, Inc.	$198 - $393	223%
Wisconsin Physicians Service Insurance Corp	$198 - $393	223%
Chorus	$200 - $397	225%

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 $365.
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 Black River Memorial Hospital 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.