CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: St Joseph's Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $501
  • Cash Discount Price: $488
  • vs. Medicare Baseline: 5.63x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at St Joseph's Hospital is $501. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $488. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 5.63x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$488

Average discount available for prompt cash payment at this facility.

Insurance Median
$501

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: $488 (549%)
Insurance Median: $501 (563%)
Cash: $488 (549% of Medicare)
Ins. Median: $501 (563% 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 563% of the Medicare baseline (a markup of 463%). 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
Cigna $78 88%
Molina Healthcare $113 - $136 127%
Meridian Health Plan $119 134%
Clear Spring Health of Illinois $136 153%
Aetna $136 - $474 153%
UnitedHealthcare $136 - $678 153%
Sae Hospice $136 153%
Blue Cross Blue Shield $136 153%
Humana $136 153%
Amish Community $190 214%
Naphcare $285 321%
Celtic Insurance Company $298 335%
Claim Doc $339 381%
Hopetrust $339 381%
Wellfirst $434 488%
First Health $501 563%
Multiplan/Phcs $576 648%
Healthlink $576 648%
Healthcare Finest Network (Hfn) $610 686%
Provider Network of America $610 686%
Current Health Solutions $678 763%
Health Alliance Medical Plans $678 763%
Qtc Medical Group of Illinois $678 763%
Caterpillar, Inc. $678 763%
Mental Health Network $678 763%
Illinois Breast and Cervical Cancer Program $678 763%
Interplan $678 763%
Consociate Group $678 763%
Healthscope $678 763%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals