X-ray, neck (cervical spine)
Facility: Kansas Heart Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $135
- Cash Discount Price: $94
- vs. Medicare Baseline: 1.52x 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 |
|---|---|---|
| Wppa - All Plans | $60 | 67% |
| Tricare | $72 | 81% |
| Medicaid / KanCare | $80 - $150 | 90% |
| Celtic Mcr Adv | $80 | 90% |
| UnitedHealthcare | $80 - $150 | 90% |
| Humana | $80 | 90% |
| Blue Cross Blue Shield | $120 - $150 | 135% |
| Multiplan - All Plans | $135 | 152% |
| Aetna | $146 - $150 | 164% |
| Celtic Mcaid - All Other Plans | $150 | 169% |
| Soonerselect Mcaid - All Plans | $150 | 169% |
Consumer Guidance & Cost Commentary
For the CPT code 72040, representing an X-ray of the cervical spine, the Kansas Heart Hospital in Wichita, KS, lists a gross charge of $150.00. This rate is significantly higher than the facility's cash median of $94.00 and the state average of $97.00. While the hospital's negotiated rates for various payers range from $60 to $150, with a median negotiated amount of $135.00, patients should note that cash payments often provide a lower baseline cost. If you have a high-deductible plan where your insurance negotiated rate exceeds the cash price, paying out-of-pocket may result in immediate savings, provided you secure a "self-pay" or "prompt-pay" discount before scheduling.
To ensure you are not overcharged, it is critical to request an itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. When evaluating the cost, compare the facility's rates against the Medicare benchmark of $88.91; the hospital's gross charge represents a markup of 1.5 times the Medicare rate, which aligns with the typical commercial range of 200% to 300% of Medicare. Commercial contracts often include administrative overhead that inflates the baseline price, so verifying your deductible status and asking for a written waiver of insurance submission can prevent unexpected balance billing or duplicate charges.