X-ray, neck (cervical spine)
Facility: Ellinwood District Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $147
- Cash Discount Price: $179
- vs. Medicare Baseline: 1.65x 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 |
|---|---|---|
| Aetna | $147 | 165% |
| Cigna | $147 | 165% |
| UnitedHealthcare | $147 | 165% |
| Blue Cross Blue Shield | $147 | 165% |
| Humana | $147 | 165% |
Consumer Guidance & Cost Commentary
For the X-ray of the neck (cervical spine) at Ellinwood District Hospital, the facility's cash price of $179.00 is lower than the average negotiated rate of $147.00 paid by major insurers like Aetna, Cigna, and UnitedHealthcare. While this facility is a Critical Access Hospital in Ellinwood, KS, and is owned by a Government Hospital District, patients with high-deductible plans may find paying the cash price upfront more cost-effective than relying on insurance, which often results in higher out-of-pocket costs due to administrative fees and claim processing delays. To secure the lowest possible rate, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as hospitals often offer significant fee reductions for upfront payment that are not automatically applied when insurance is involved.
It is important to note that the facility's gross charge of $210.00 represents the maximum list price, but the actual amount billed to an insured patient is capped at the negotiated rate of $147.00. Although the data does not provide specific county or state average comparisons for this procedure, the Medicare benchmark of $88.91 serves as a reliable baseline for evaluating pricing fairness, showing that the commercial negotiated rate is significantly higher than the federal standard. Consumers should avoid accepting summary bills and instead demand a detailed, itemized statement to ensure no errors or unbundled charges exist, as over 80% of hospital bills contain discrepancies that can be resolved through a formal written audit dispute.