CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mon Health Medical Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $600
  • Cash Discount Price: $333
  • vs. Medicare Baseline: 6.75x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mon Health Medical Center is $600. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $333. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 6.75x the Medicare baseline. Located in 1200 Jd Anderson Drive, Morgantown, WV.
Cash / Self-Pay
$333

Average discount available for prompt cash payment at this facility.

Insurance Median
$600

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: $333 (375%)
Insurance Median: $600 (675%)
Cash: $333 (375% of Medicare)
Ins. Median: $600 (675% 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 675% of the Medicare baseline (a markup of 575%). 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
Unison_Plan $16 18%
Gateway_Health_Plan $18 20%
Aetna $54 - $84 61%
Zelis_Other_Plan $72 81%
The_Health_Plan_Peia_Plan $83 93%
Blue Cross Blue Shield $84 - $422 94%
Health_South_Mountain_View_Plan $84 94%
Humana $84 - $620 94%
Medicare (plans) $84 94%
Paramount_Elite_Plan $84 94%
Uhc_Va_Plan $84 94%
Zelis_Group_Health_Plan $84 94%
Seven_Corners_Plan $168 189%
Maryland_Physicians_Care_Plan $467 - $482 525%
The_Health_Plan_Murray_Energy_Commercial_Aso_Plan $533 - $551 599%
The_Health_Plan_Plan $573 - $593 644%
Acpn_Plan $600 - $620 675%
Cigna $600 - $620 675%
Mon_County_Commission_Plan $600 - $620 675%
Uhc_Plan $600 - $620 675%
Health_Payors_Organization_Plan $613 - $634 689%
Uhc_Options_Ppo_Plan $620 - $641 697%
Multiplan_Phcs_Plan $633 - $655 712%
Mutual_Of_Omaha_Plan $633 - $655 712%
Geha_Plan $647 - $668 728%
Three_Rivers_Plan $647 - $668 728%
Uhc_Onenet_Ppo_Plan $647 - $668 728%
Upmc__Plan $647 - $668 728%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Jd Anderson Drive, Morgantown, WV 26505
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals