CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Kona Community Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $113
Cash Discount Price: $372
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Kona Community Hospital is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $372. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.27x the Medicare baseline. Located in 79-1019 Haukapila Street, Kealakekua, HI.

Cash / Self-Pay

$372

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $372 (418%)

Insurance Median: $113 (127%)

Cash: $372 (418% of Medicare)

Ins. Median: $113 (127% 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.

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
Hawaii Medical Service Association	$20 - $129	22%
Hmsa	$20 - $114	22%
UnitedHealthcare	$20 - $114	22%
Uha	$54	61%
Hmaa	$55	62%
Hma	$62	70%
University Health Alliance	$74	83%
Hawaii Western Management Group	$103	116%
Ohana Health Plan	$103 - $113	116%
Humana	$103 - $114	116%
Kaiser Permanente	$103 - $361	116%
Alohacare	$103 - $114	116%
Devoted Health	$113	127%
Ohana	$114 - $125	128%
Kaiser	$114	128%
Health Management Network	$486 - $487	547%
Mdx Hawaii	$555 - $556	624%

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 $372.
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 Kona Community 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.