72040

X-ray of upper spine, 2-3 views

Medicare pricing data for 67,421 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $12 in Maine to $34 in New Jersey. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

X-ray of upper spine, 2-3 views (HCPCS code 72040) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $24.16, but hospitals typically charge $93.34 — a 3.9x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$4.83

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $24.16, your out-of-pocket cost would be approximately $4.83. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$24.16
Average Hospital Charge
$93.34
Markup Ratio
3.9x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$93.34
Medicare Allowed$24.16
Medicare Payment$17.57

Hospitals charge 3.9x more than what Medicare allows for this procedure. Medicare actually pays $17.57 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$34$1471,73613,533+39.9%
California$29$1135,51653,699+22.1%
Alaska$29$1632131,937+21.9%
Florida$29$1114,07040,017+19.0%
New York$29$1132,87933,265+18.8%
Maryland$29$801,25918,187+18.6%
Arizona$28$1151,10012,270+16.8%
Puerto Rico$28$34172853+16.6%
District of Columbia$28$871591,768+15.1%
Wyoming$28$1271531,315+15.0%
Nevada$28$1285654,378+14.7%
Connecticut$27$918967,098+11.7%
Alabama$26$791,53611,984+9.6%
Delaware$26$951852,373+8.6%
Georgia$26$1192,46919,833+8.2%
Rhode Island$25$812411,821+3.2%
North Carolina$25$863,25622,993+2.8%
Virginia$25$971,85517,789+2.4%
Texas$25$1014,91053,967+1.9%
South Carolina$24$931,57314,606+0.8%
Tennessee$24$852,31520,199+0.6%
Colorado$24$811,20910,077-2.1%
New Hampshire$23$1233643,832-5.9%
Louisiana$23$831,08612,588-6.8%
Kentucky$22$709427,756-10.1%
Illinois$22$1042,30622,181-10.8%
Mississippi$22$779179,201-10.8%
New Mexico$21$843142,282-11.1%
Washington$21$831,61412,349-11.9%
Indiana$21$891,39714,818-12.4%
Arkansas$21$651,12910,492-13.1%
Hawaii$21$751791,273-13.4%
Oklahoma$21$711,23510,657-15.0%
Utah$20$575793,551-15.2%
Michigan$20$731,61013,433-16.4%
Minnesota$20$811,74914,156-17.2%
Kansas$20$688926,229-17.8%
Massachusetts$20$721,21213,182-17.8%
Pennsylvania$20$752,28420,166-18.8%
South Dakota$19$593172,296-20.8%
Oregon$19$608627,331-21.7%
Wisconsin$19$1351,38610,268-21.8%
Ohio$19$682,04721,076-22.2%
Nebraska$19$637145,053-23.3%
Iowa$18$728726,898-24.0%
Missouri$18$651,57415,297-25.7%
Montana$17$552872,341-30.8%
Idaho$16$814032,690-32.0%
North Dakota$16$651721,590-32.9%
Vermont$14$6395677-43.8%
West Virginia$14$653252,415-44.0%
Maine$12$482371,360-49.0%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber