CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Stoughton Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $244
  • Cash Discount Price: $305
  • vs. Medicare Baseline: 2.74x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Stoughton Hospital is $244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $305. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.74x the Medicare baseline. Located in 900 Ridge St, Stoughton, WI.
Cash / Self-Pay
$305

Average discount available for prompt cash payment at this facility.

Insurance Median
$244

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: $305 (343%)
Insurance Median: $244 (274%)
Cash: $305 (343% of Medicare)
Ins. Median: $244 (274% 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 274% of the Medicare baseline (a markup of 174%). 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
Medicaid / KanCare $67 75%
Tricare $132 148%
Healthnet Mcr Adv - All Plans $148 166%
Dean Health Insurance Med Adv $155 174%
Humana $155 - $500 174%
Quartz Mcr Adv $155 174%
Security Health/First Health - All Plans $155 174%
Aetna $166 - $472 187%
Dean Health Insurance Comm - All Other Plans $243 273%
Dean Health Insurance Epo $243 273%
UnitedHealthcare $244 - $444 274%
Quartz Health Solutions - All Other Lans $327 368%
Geha - All Plans $416 468%
Cigna $444 499%
Wisconsin Ppo Ppa Direct - All Plans $444 499%
Blue Cross Blue Shield $483 543%
Wps - All Plans $500 562%
Alliance - All Plans $2,220 2497%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 900 Ridge St, Stoughton, WI 53589
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals