CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mercy Hospital Pittsburg, Inc

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $87
  • Cash Discount Price: $395
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mercy Hospital Pittsburg, Inc is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $395. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 0.98x the Medicare baseline. Located in 1 Mt Carmel Way, Pittsburg, KS.
Cash / Self-Pay
$395

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

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: $395 (444%)
Insurance Median: $87 (98%)
Cash: $395 (444% of Medicare)
Ins. Median: $87 (98% 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.

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
Medicaid / KanCare $24 - $86 27%
Humana $24 - $84 27%
Aetna $24 - $517 27%
Blue Cross Blue Shield $49 - $192 55%
UnitedHealthcare $75 - $410 84%
Halo Hcr Inc Hospice [20432] $84 94%
Kindful Hospice Contracted [320434] $84 94%
Cross Timbers Hospice [20098] $84 94%
Dept Of Veteran Affairs Contracted [320106] $84 94%
Elara Caring Aspire Hospice [20433] $84 94%
Medicare (plans) $84 - $88 94%
Kindful Hospice [20434] $84 94%
Pace Of The Ozarks Contracted [320518] $84 94%
Tricare $84 94%
American Health Advantage Of Ks Mcr Contracted [320508] $84 94%
Mercy Hospice Okc [20252] $84 94%
Halo Hcr Inc Hospice Contracted [320432] $84 94%
Ambetter / Centene $86 97%
Home State Health Plan Contracted [320187] $86 97%
Providrs Care Network Contracted [320484] $163 183%
Health Choice Contracted [320166] $198 223%
Medica Contracted [320239] $221 249%
Cigna $242 - $248 272%
United Medical Resources Contracted [320454] $410 461%
Imagine 360 Contracted [320494] $486 547%
Ebms Contracted [320493] $486 547%
Healthlink Contracted [320179] $486 547%
Reflect Health Contracted [320492] $486 547%
Aither Health Contracted [320449] $486 547%
American Healthcare Alliance Contracted [320020] $486 547%
Auxiant Contracted [320462] $486 547%
Yuzu Health Contracted [320521] $486 547%
Edison Health Solutions Contracted [320502] $486 547%
Workers Comp [20426] $486 547%
Mercy Benefit Admin Contracted [320251] $486 547%
First Health Contracted [320128] $517 581%

Consumer Guidance & Cost Commentary

For the X-ray of the cervical spine at Mercy Hospital Pittsburg, Inc., the facility's cash price is $395.00, which is significantly lower than the negotiated rates charged to most insurance plans. While the facility's cash rate is also lower than the state average for this procedure, patients with high-deductible plans may find the cash price more affordable than their insurance allowed amounts, which range from $84 to $517 depending on the carrier. It is important to note that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40% compared to direct cash payments.

To minimize costs, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can bypass costly claims processing and reduce the final bill. Additionally, because over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded statement rather than accepting a summary invoice, which may obscure unbundled charges or services not rendered. By comparing the facility's rates directly to the Medicare benchmark of $88.91, patients can see that while the cash price is higher than the federal baseline, it remains substantially lower than the commercial rates charged by many in-network payers.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Mt Carmel Way, Pittsburg, KS 66762
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals