X-ray, neck (cervical spine)
Facility: Lmh
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $88
- Cash Discount Price: $203
- vs. Medicare Baseline: 0.99x 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 |
|---|---|---|
| Cigna | $33 - $541 | 37% |
| Humana | $33 - $88 | 37% |
| Medicare (plans) | $33 - $88 | 37% |
| UnitedHealthcare | $33 - $538 | 37% |
| Haskell Indian Health Services | $38 - $88 | 43% |
| Blue Cross Blue Shield | $38 - $524 | 43% |
| Ambetter / Centene | $39 - $136 | 44% |
| Allwell | $39 - $89 | 44% |
| Aetna | $516 - $673 | 580% |
| Non Contracted | $648 | 729% |
| First Health | $754 | 848% |
Consumer Guidance & Cost Commentary
For this X-ray of the cervical spine at Lawrence, KS, the facility's cash price of $203.00 is significantly lower than the gross charge of $810.00 and the Medicare benchmark of $88.91. While the cash rate is higher than the Medicare amount, it remains well below the negotiated rates paid by major insurers like Aetna ($516–$673) and UnitedHealthcare ($33–$538). Patients with high-deductible plans may find paying the $203.00 cash price more cost-effective than relying on insurance, which could result in a higher allowed amount due to administrative markups and contract dynamics. To minimize costs, patients should contact the hospital directly to confirm if a "self-pay" or "prompt-pay" discount is available, as these upfront payment incentives can further reduce the final bill.
The data indicates that this facility, owned by the local government, has a strong consumer rating of 4 stars and operates in a competitive market with 11 different payers. While the cash rate is lower than the negotiated rates for most commercial plans, it is important to note that commercial rates often include administrative overhead that can inflate the baseline price by 20% to 40%. If a patient receives care from an out-of-network provider at this facility, they should be aware of the No Surprises Act, which protects against balance billing for emergency services and non-emergency services from out-of-network providers at in-network facilities. Consumers are advised to request a full itemized bill before paying any invoice to ensure no unbundled codes or services not rendered are included, as summary bills often obscure these potential