X-ray, neck (cervical spine)
Facility: Wichita County Health Center
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $373
- Cash Discount Price: $327
- vs. Medicare Baseline: 4.20x 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 420% of the Medicare baseline (a markup of 320%). 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 |
|---|---|---|
| Medicaid / KanCare | $337 | 379% |
| UnitedHealthcare | $409 | 460% |
Consumer Guidance & Cost Commentary
For this X-ray of the cervical spine at Wichita County Health Center in Leoti, Kansas, the facility's cash price of $327.00 is notably lower than the median negotiated rate of $373.00 and the gross charge of $409.00. While the facility is a Critical Access Hospital with government-local ownership, patients should be aware that insurance plans often pay more than the cash price due to administrative overhead and contract structures. Specifically, the median amount paid by UnitedHealthcare is $409.00, which matches the gross charge, whereas Medicaid/KanCare pays the same amount as the negotiated rate of $373.00. This suggests that for patients with high-deductible plans, paying the cash price of $327.00 upfront could result in significant savings compared to using insurance, provided the patient's deductible has been met.
When evaluating value against state and county benchmarks, it is important to compare rates to the Medicare benchmark rather than the hospital's inflated list price. The Medicare amount for this service is $88.91, which serves as the objective baseline for fair pricing; commercial rates typically range from 200% to 300% of this figure, while fair pricing is generally defined as 120% to 150%. Although the data does not provide specific county or state average comparisons for this code, the facility's cash rate of $327.00 represents a substantial discount from the gross charge, illustrating the potential for savings when bypassing insurance billing cycles. Patients are encouraged to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are