X-ray, neck (cervical spine)
Facility: Mercy Hospital Columbus
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $349
- Cash Discount Price: $313
- vs. Medicare Baseline: 3.93x 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 393% of the Medicare baseline (a markup of 293%). 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 |
|---|---|---|
| Centivo Contracted [320505] | $5 | 6% |
| Medicaid / KanCare | $24 - $349 | 27% |
| Humana | $24 - $457 | 27% |
| Blue Cross Blue Shield | $75 - $349 | 84% |
| UnitedHealthcare | $75 - $399 | 84% |
| Medicare (plans) | $82 - $363 | 92% |
| Insurance System Inc Contracted [320465] | $207 | 233% |
| Health Systems Inc Contracted [320174] | $207 | 233% |
| Administrative Payor Contracted [320005] | $216 | 243% |
| Pace Of The Ozarks Contracted [320518] | $349 | 393% |
| Qual Choice Contracted [320325] | $349 | 393% |
| Aetna | $349 - $433 | 393% |
| Home State Health Plan Contracted [320187] | $349 | 393% |
| Elara Caring Aspire Hospice [20433] | $349 | 393% |
| Globalhealth Contracted [320145] | $349 | 393% |
| Kindful Hospice [20434] | $349 | 393% |
| Ambetter / Centene | $349 | 393% |
| Kindful Hospice Contracted [320434] | $349 | 393% |
| Halo Hcr Inc Hospice [20432] | $349 | 393% |
| Centurion Of Missouri [20459] | $349 | 393% |
| Mercy Mgd Behavioral Health Contracted [320259] | $349 | 393% |
| Dept Of Veteran Affairs Contracted [320106] | $349 | 393% |
| Cigna | $349 | 393% |
| Cherokee Nation Health Serv Contracted [320066] | $349 | 393% |
| Halo Hcr Inc Hospice Contracted [320432] | $349 | 393% |
| Mercy Hospice Okc [20252] | $349 | 393% |
| Novasys Contracted [320285] | $349 | 393% |
| Medical Associates Health Contracted [320444] | $349 | 393% |
| Cross Timbers Hospice [20098] | $349 | 393% |
| Indian Health Service Contracted [320198] | $349 | 393% |
| Provider Partners Health Plans Contracted [320450] | $349 | 393% |
| Tricare | $350 | 394% |
| Healthscope Contracted [320182] | $371 | 417% |
| Workers Comp [20426] | $385 - $409 | 433% |
| United Medical Resources Contracted [320454] | $399 - $457 | 449% |
| Medica Contracted [320239] | $431 | 485% |
| American Healthcare Alliance Contracted [320020] | $433 | 487% |
| Preferred Health Plan Contracted [320522] | $433 | 487% |
| Usa Managed Care Org Contracted [320429] | $433 | 487% |
| First Health Contracted [320128] | $433 | 487% |
| Healthlink Contracted [320179] | $433 - $457 | 487% |
| Federal Medical Center Contracted [320127] | $433 | 487% |
| Mercy Benefit Admin Contracted [320251] | $433 - $457 | 487% |
| Reflect Health Contracted [320492] | $457 | 514% |
| Private Health Care Systems Contracted [320320] | $457 | 514% |
| Aither Health Contracted [320449] | $457 | 514% |
| Benefit Management Contracted [320052] | $457 | 514% |
| Ebms Contracted [320493] | $457 | 514% |
| Yuzu Health Contracted [320521] | $457 | 514% |
| Imagine 360 Contracted [320494] | $457 | 514% |
| Edison Health Solutions Contracted [320502] | $457 | 514% |
| 90 Degree Benefits Contracted [320436] | $457 | 514% |
| Auxiant Contracted [320462] | $457 | 514% |
| Show-Me Health Administrators Contracted [320483] | $457 | 514% |
| Ppo Plus Contracted [320310] | $457 | 514% |
| Point C Contracted [320238] | $457 | 514% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Mercy Hospital Columbus, the facility's cash price of $313.00 is notably lower than the median negotiated rate of $349.00 paid by most commercial payers, including Humana, Blue Cross Blue Shield, and UnitedHealthcare. While Medicare reimburses $88.91 for this service, the facility's cash rate represents a significant discount compared to the standard insurance allowed amounts. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $313.00 rate is lower than the typical negotiated ceiling of $349.00, effectively bypassing the administrative overhead and markup layers that commercial contracts often include.
To secure the lowest possible cost, patients should proactively request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the final bill further than the standard cash rate. It is important to verify your deductible status before relying on insurance, as paying the negotiated rate without meeting your deductible may result in higher out-of-pocket expenses than paying the cash price outright. Additionally, while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should always request an itemized bill to ensure no unbundled charges or errors exist, as over 80% of hospital bills contain discrepancies that can be resolved through a formal audit.