X-ray, neck (cervical spine)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $80
- Cash Discount Price: $239
- 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 |
|---|---|---|
| Humana | $78 | 88% |
| Blue Cross Blue Shield | $80 - $120 | 90% |
| UnitedHealthcare | $80 - $97 | 90% |
| Aetna | $80 - $100 | 90% |
| United Mine Workers Of America | $80 | 90% |
| Providrs Care Network | $80 | 90% |
| Lantern Specialty Care | $128 | 144% |
Consumer Guidance & Cost Commentary
For the X-ray of the neck (cervical spine) at Kansas Spine & Specialty Hospital, Llc in Wichita, KS, the cash median price is $239.00, which is lower than the facility's gross charge of $368.00. While the facility is a Physician-owned Acute Care Hospital, patients with high-deductible plans may find that paying cash upfront is more cost-effective than using insurance, as the negotiated rates paid by major payers like Blue Cross Blue Shield and UnitedHealthcare range from $80 to $120, yet administrative overhead often inflates the final allowed amount. It is important to note that while the facility's cash rate is competitive, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can further reduce the total cost by bypassing the administrative fees associated with insurance claims processing.
The facility's pricing is benchmarked against Medicare, which sets a baseline rate of $88.91 for this procedure; the cash median of $239.00 represents a markup relative to this federal standard, though it remains significantly lower than the gross charges. Commercial negotiated rates vary by insurer, with the lowest allowed amount being $78 and the highest reaching $128, meaning patients must confirm their specific plan's allowed amount to avoid unexpected balance billing. If a patient receives care from an out-of-network provider or encounters services billed separately, they should request an itemized audit to identify any unbundled codes or services not rendered, as federal protections like the No Surprises Act may apply to prevent balance billing for emergency or non-emergency services at in-network facilities.