X-ray, neck (cervical spine)
Facility: Lane County Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $234
- Cash Discount Price: $234
- vs. Medicare Baseline: 2.63x 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 263% of the Medicare baseline (a markup of 163%). 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 |
|---|---|---|
| Aetna | $211 - $223 | 237% |
| UnitedHealthcare | $211 - $234 | 237% |
| Healthy Blue Mcr Adv - All Other Plans | $234 | 263% |
| Healthy Blue Mcaid | $234 | 263% |
| Medicaid / KanCare | $234 - $258 | 263% |
| Wppa Providers-All Plans | $351 | 395% |
Consumer Guidance & Cost Commentary
For the CPT code 72040, representing an X-ray of the neck (cervical spine), Lane County Hospital in Dighton, KS, lists a cash median price of $234.00, which matches the facility's negotiated median rate. This cash price is significantly higher than the Medicare benchmark of $88.91, reflecting a markup of 2.6 times the federal rate. While commercial payers like Aetna and UnitedHealthcare have negotiated ranges starting at $211, these rates often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket directly. It is important to note that the facility is a Critical Access Hospital owned by a Government Hospital District, and patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to ensure they are not paying the full negotiated amount.
When reviewing your final bill, be aware that hospitals may issue summary bills that obscure individual charges, so always request a full itemized statement to identify any unbundled codes or services not rendered. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, unexpected charges can still occur if ancillary services like lab tests are billed separately. To avoid overpaying, compare the facility's rates against the broader market; while specific county or state average data for this exact procedure is not provided in this report, understanding that commercial rates often average 200% to 300% of Medicare can help you evaluate if the $234.00 rate is reasonable. If you receive a bill, dispute any errors in writing and do not sign away your