X-ray, neck (cervical spine)
Facility: Grisell Memorial Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $235
- Cash Discount Price: $257
- vs. Medicare Baseline: 2.64x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 264% of the Medicare baseline (a markup of 164%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Blue Cross Blue Shield | $150 | 169% |
| UnitedHealthcare | $201 - $270 | 226% |
| Humana | $270 | 304% |
| Medicaid / KanCare | $270 | 304% |
Consumer Guidance & Cost Commentary
This X-ray service for the cervical spine at Grisell Memorial Hospital in Ransom, KS, has a cash median price of $257.00, which is slightly lower than the facility's negotiated rates of $235.00 paid by major insurers like UnitedHealthcare and Blue Cross Blue Shield. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find paying cash directly more cost-effective than relying on insurance, as the cash price is already below the negotiated amounts. It is important to note that commercial rates often include administrative overhead and contract markups that can exceed the true cost of care, making the cash option a potentially smarter financial choice for self-pay patients.
For those seeking to minimize out-of-pocket expenses, you should actively request a "prompt-pay" discount or self-pay rate before scheduling your visit, as these upfront incentives can significantly reduce the final bill. If you do receive a bill after insurance processing, you have the right to request an itemized billing audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Additionally, under the No Surprises Act, you are protected from balance billing for emergency care or non-emergency services at in-network facilities, so any unexpected charges should be disputed with the insurer rather than paid immediately.