X-ray, neck (cervical spine)
Facility: Nmc Health
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $70
- Cash Discount Price: $145
- vs. Medicare Baseline: 0.79x 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 |
|---|---|---|
| Bluestem Pace | $36 - $84 | 40% |
| Wppa | $41 - $186 | 46% |
| Occunet | $44 - $203 | 49% |
| Samaritan Ministries International | $48 - $220 | 54% |
| Medincrease Health Plan | $48 - $220 | 54% |
| Aetna | $52 - $61 | 58% |
| Prime Health Services | $56 - $254 | 63% |
| Leading Age | $57 - $134 | 64% |
| Medicaid / KanCare | $57 - $134 | 64% |
| UnitedHealthcare | $67 - $305 | 75% |
| Cigna | $70 - $322 | 79% |
| Blue Cross Blue Shield | $160 | 180% |
Consumer Guidance & Cost Commentary
For the CPT code 72040, representing an X-ray of the neck (cervical spine), Nmc Health in Newton, KS, lists a cash median price of $145.00. This cash rate is notably lower than the facility's gross charge of $244.00 and significantly lower than the negotiated rates paid by most commercial payers, which range from $36 to $322 depending on the insurance plan. While the facility's negotiated rates are generally higher than the cash price, patients with high-deductible plans may find paying the cash median of $145.00 upfront more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible has not been met. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final amount owed.
When evaluating this service, it is important to understand that commercial insurance contracts often result in negotiated rates that exceed the cash price due to administrative overhead and contract dynamics. The facility's negotiated rate of $70.00 represents a median across plans, though individual allowed amounts vary widely, with some payers like Blue Cross Blue Shield negotiating a fixed rate of $160.00. For context, the Medicare benchmark for this procedure is $88.91, which serves as a scientifically validated baseline for the true cost of delivery. Patients should be aware that balance billing is largely prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but they must still carefully review itemized bills to ensure no unbund