X-ray, neck (cervical spine)
Facility: Saint John Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $82
- Cash Discount Price: $81
- vs. Medicare Baseline: 0.92x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Comp Alliance Workers Comp | $32 | 36% |
| Oha Networks | $35 | 39% |
| Worker Compensation | $36 | 40% |
| Medicaid / KanCare | $49 | 55% |
| Aetna | $54 - $82 | 61% |
| UnitedHealthcare | $74 - $115 | 83% |
| Celtic | $75 - $131 | 84% |
| Healthy Blue | $75 - $86 | 84% |
| Blue Cross Blue Shield | $76 - $160 | 85% |
| Midland Care Connection | $82 | 92% |
| Cigna | $82 | 92% |
| Medicare (plans) | $82 | 92% |
| Tricare | $82 | 92% |
| Kansas Superior Select | $84 | 94% |
| Employer Direct Healthcare | $115 | 129% |
| Corizon | $115 | 129% |
| Well Path | $115 | 129% |
| Centurion | $123 | 138% |
| Naphcare | $127 | 143% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Saint John Hospital in Leavenworth, Kansas, the cash price is $81.00, which is significantly lower than the facility's negotiated rates and the state average. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $49 to $160, and the median negotiated rate across all payers is $82.00, paying cash directly can result in substantial savings. This aligns with the principle that cash-pay options are often the most economical choice for patients with high-deductible plans, as the insurance negotiated rate frequently exceeds the cash price. To maximize savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront fee reductions can bypass the administrative overhead and multi-layered contract structures that inflate commercial billing.
The facility's cash rate of $81.00 also compares favorably to the Medicare benchmark of $88.91, indicating that the cash price is slightly below the federal government's cost-based standard. However, it is important to note that commercial insurance rates often average 200% to 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of this baseline. Since the facility is a voluntary non-profit acute care hospital, patients should verify their specific plan's allowed amount, as some in-network contracts may still result in higher out-of-pocket costs than the cash option. Consumers are advised to avoid accepting summary bills that obscure individual charges and instead demand a full itemized statement to ensure no unbundled codes or services not rendered are included in the final invoice.