CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Childrens Hospital of Wisconsin

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $268
  • Cash Discount Price: $174
  • vs. Medicare Baseline: 3.01x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Childrens Hospital of Wisconsin is $268. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 3.01x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$174

Average discount available for prompt cash payment at this facility.

Insurance Median
$268

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: $174 (196%)
Insurance Median: $268 (301%)
Cash: $174 (196% of Medicare)
Ins. Median: $268 (301% 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 301% of the Medicare baseline (a markup of 201%). 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
Froedtert Health $222 - $269 250%
Medical College Of Wisconsin $222 250%
Network Health Plan $226 254%
UnitedHealthcare $233 - $241 262%
Aspirus Health Plan $238 268%
Common Ground Healthcare Cooperative $238 - $269 268%
Trilogy Health Solutions $238 - $269 268%
Wps Health Plan $241 - $285 271%
Advocate Aurora Healthcare $244 274%
Blue Cross Blue Shield $247 - $301 278%
Centivo $247 278%
Health Partners $247 - $279 278%
Employer Health Care Alliance Cooperative $249 280%
Dean Health Plan $254 286%
Group Health Cooperative Of Eau Claire $254 286%
Oan Llc $254 286%
Security Health Plan $263 296%
Health Payment Systems $268 301%
Praire States $269 303%
Quartz Health Insurance $269 303%
Sheboygan Employer'S Health Network $269 303%
Mayo Clinic Health Solutions $276 310%
Aetna $279 - $282 314%
Bellin Thedacare $285 321%
Cigna $285 321%
Group Health Cooperative Of South Central Wisconsin $285 321%
Prevea Health Network $285 321%
Multiplan $288 - $301 324%
Coventry Health Care $301 339%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens