CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Margaretville Memorial Hospital

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72040
Insurance Median: $224
Cash Discount Price: $510
vs. Medicare Baseline: 2.52x Medicare

The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Margaretville Memorial Hospital is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $510. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.52x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$510

Average discount available for prompt cash payment at this facility.

Insurance Median

$224

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: $510 (574%)

Insurance Median: $224 (252%)

Cash: $510 (574% of Medicare)

Ins. Median: $224 (252% 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 252% of the Medicare baseline (a markup of 152%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$89 - $510	100%
Mvp	$121	136%
Emblem	$124 - $146	139%
Oxford	$128	144%
Oxford Exchange	$128	144%
UnitedHealthcare	$128 - $224	144%
Mvp Hmo/Ppo	$143	161%
Blue Cross Blue Shield	$147 - $224	165%
Self-Pay	$211	237%
Medicare (plans)	$224 - $337	252%
Mvp Gold (McR)	$224	252%
Hamaspik (McR)	$224	252%
Affinity By Molina McR	$236	265%
Cdphp	$247	278%
Emblem Ghi/Hip Ppo/Cbp	$316	355%
Mvp Exchange	$332	373%
Emblem Select Care (Exchange)	$347	390%
Magnacare Standard	$357	402%
Todays Options	$370	416%
Magnacare Preferred	$408	459%
Emblem Ghi/Hip Hmo/Epo/Pos	$408	459%
Multiplan	$418	470%
First Health	$459	516%

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 $510.
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 Margaretville Memorial 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.