X-ray, neck (cervical spine)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $603
- Cash Discount Price: $313
- vs. Medicare Baseline: 6.78x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 678% of the Medicare baseline (a markup of 578%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Hooray Health [8000] | $428 | 481% |
| Blue Cross Blue Shield | $428 | 481% |
| Oncology Patient Assistance Programs [2295] | $428 | 481% |
| Healthcare Highways [2210] | $428 | 481% |
| Aetna | $428 | 481% |
| Lucent Health [6000] | $428 | 481% |
| Black Lung [6055] | $428 | 481% |
| Web Tpa [2115] | $428 | 481% |
| Department Of Corrections [1340] | $522 | 587% |
| National Association Of Letter Carriers [1695] | $603 | 678% |
| Healthpartners [1500] | $603 | 678% |
| Cigna | $603 | 678% |
| American Postal Workers Union [1070] | $603 | 678% |
| Humana | $616 | 693% |
| Multiplan [1680] | $811 | 912% |
| Administrative Concepts [1005] | $811 | 912% |
| American Healthcare [1055] | $811 | 912% |
| First Health [1375] | $811 | 912% |
| Healthscope Benefits [2290] | $852 | 958% |
| UnitedHealthcare | $852 | 958% |
| Geha [1415] | $852 | 958% |
| Coventry Healthcare [1320] | $856 | 963% |
| Ks Disability Determination [6090] | $1,044 | 1174% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at the University of Kansas Health System - St Francis Campus, the facility's negotiated rate of $603 is significantly higher than the cash price of $313, though both figures remain well below the gross charge of $1,044. While the facility is in-network for major payers like UnitedHealthcare and Aetna, the negotiated amount of $603 exceeds the Medicare benchmark of $88.91 by a substantial margin, reflecting the typical administrative markup inherent in commercial contracts. Patients with high-deductible plans or those without insurance may find the cash price more advantageous, as paying the $313 cash rate directly could result in lower out-of-pocket costs compared to the $603 allowed by insurance plans, provided they qualify for the facility's self-pay or prompt-pay discounts.
The facility's pricing structure shows a consistent range across most payers, with the majority of negotiated rates clustering between $428 and $616, while the highest negotiated amount listed is $1,044 for specific government programs. Although the data does not provide explicit state or county average comparisons for this specific CPT code, the facility's location in Topeka, KS, suggests that commercial rates are subject to regional wage indexes that influence the baseline for these contracts. To ensure you are receiving the most accurate pricing, it is recommended to request an itemized bill before finalizing payment, as summary invoices can obscure individual line items that may contain errors or unbundled charges. Additionally, verifying your deductible status before scheduling is crucial, as paying the negotiated rate without meeting your plan's deductible could lead to unexpected financial exposure.