X-ray, neck (cervical spine)
Facility: Pratt Regional Medical Center
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $80
- Cash Discount Price: $60
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Christian Health Aid | $24 - $353 | 27% |
| UnitedHealthcare | $27 - $479 | 30% |
| Health Partners Of Kansas | $27 - $400 | 30% |
| Aetna | $29 - $423 | 33% |
| Choicecare | $32 - $470 | 36% |
| Celtic Insurance Company | $84 | 94% |
| Healthy Blue | $87 | 98% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Pratt Regional Medical Center in Pratt, KS, the facility's cash price of $60.00 is lower than the state average for this service, which is $85.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $27 to $479, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, unexpected charges can still occur for out-of-network ancillary services like emergency physicians or lab tests. Patients should verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not being billed the full chargemaster rate.
The Medicare benchmark for this procedure is $88.91, which serves as a reliable baseline for evaluating the facility's pricing; the cash rate of $60.00 represents a significant discount compared to this federal standard. Although the facility's overall rating is 4 out of 5, the wide variation in negotiated rates among payers—ranging from a fixed $84 with Celtic Insurance Company to $479 with Choicecare—highlights that insurance coverage does not guarantee a uniform price. To avoid potential billing errors, patients should request a full itemized bill that lists every CPT code and unit cost, as over 80% of hospital bills contain mistakes such as double-billing or unbundled charges. If a discrepancy is found, a formal written dispute sent to the