CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Mercy Specialty Hospital Southeast Kansas

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $104
  • Cash Discount Price: $283
  • vs. Medicare Baseline: 1.17x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Mercy Specialty Hospital Southeast Kansas is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $283. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 1.17x the Medicare baseline. Located in 1619 K 66, Galena, KS.
Cash / Self-Pay
$283

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $283 (318%)
Insurance Median: $104 (117%)
Cash: $283 (318% of Medicare)
Ins. Median: $104 (117% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $24 - $84 27%
Medicaid / KanCare $24 - $84 27%
Humana $24 - $86 27%
Provider Partners Health Plans Contracted [320450] $26 29%
First Health Contracted [320128] $27 30%
Blue Cross Blue Shield $49 - $130 55%
UnitedHealthcare $75 - $403 84%
Kindful Hospice [20434] $84 94%
Globalhealth Contracted [320145] $84 94%
Elara Caring Aspire Hospice [20433] $84 94%
Pace Of The Ozarks Contracted [320518] $84 94%
Cross Timbers Hospice [20098] $84 94%
Qual Choice Contracted [320325] $84 94%
Mercy Hospice Okc [20252] $84 94%
Mercy Mgd Behavioral Health Contracted [320259] $84 94%
Medicare (plans) $84 94%
Halo Hcr Inc Hospice Contracted [320432] $84 94%
Medical Associates Health Contracted [320444] $84 94%
Kindful Hospice Contracted [320434] $84 94%
Halo Hcr Inc Hospice [20432] $84 94%
Cherokee Nation Health Serv Contracted [320066] $84 94%
Tricare $84 94%
Cigna $84 - $248 94%
Centivo Contracted [320505] $86 97%
Dept Of Veteran Affairs Contracted [320106] $86 97%
United Medical Resources Contracted [320454] $102 - $104 115%
Insurance System Inc Contracted [320465] $104 117%
Healthscope Contracted [320182] $104 - $327 117%
Benefit Management Contracted [320052] $104 117%
Health Systems Inc Contracted [320174] $104 117%
Point C Contracted [320238] $104 - $327 117%
Medica Contracted [320239] $159 179%
Providrs Care Network Contracted [320484] $163 183%
Mercy Benefit Admin Contracted [320251] $173 - $305 195%
Show-Me Health Administrators Contracted [320483] $173 195%
Ebms Contracted [320493] $305 343%
Auxiant Contracted [320462] $305 - $327 343%
Aither Health Contracted [320449] $305 343%
Yuzu Health Contracted [320521] $305 343%
Reflect Health Contracted [320492] $305 343%
Imagine 360 Contracted [320494] $305 343%
Edison Health Solutions Contracted [320502] $305 343%
American Healthcare Alliance Contracted [320020] $305 343%
Preferred Health Plan Contracted [320522] $327 368%
Federal Medical Center Contracted [320127] $327 368%
Healthlink Contracted [320179] $327 368%
Compcare Of The Ozarks Contracted [320437] $344 387%
Workers Comp [20426] $349 393%
Private Health Care Systems Contracted [320320] $403 453%
Multiplan [20270] $414 466%
Multiplan Contracted [320270] $414 466%

Consumer Guidance & Cost Commentary

For the X-ray of the cervical spine (CPT code 72040) at Mercy Specialty Hospital Southeast Kansas, the facility's cash median rate is $283.00, which is 1.2 times the Medicare benchmark of $88.91. While many commercial payers negotiate rates significantly higher than the cash price—ranging from $84 to $414 depending on the insurer—patients with high-deductible plans may find paying the cash rate directly more affordable than facing a negotiated bill that exceeds their deductible. It is important to note that the facility's cash rate is substantially lower than the highest negotiated rates found in the data, such as the $414 rate from Multiplan, highlighting that the cash price can serve as a competitive baseline for self-pay patients.

To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Since the facility is an in-network location for most major payers listed, the No Surprises Act generally protects patients from balance billing for out-of-network services at this acute care hospital, though verifying the specific status of any ancillary services is still recommended. Before scheduling, consumers should confirm their deductible status and request an itemized bill to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1619 K 66, Galena, KS 66739
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals