X-ray, neck (cervical spine)
Facility: Rooks County Health Center
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $266
- Cash Discount Price: $222
- vs. Medicare Baseline: 2.99x 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 299% of the Medicare baseline (a markup of 199%). 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 |
|---|---|---|
| Celtic Mcr Adv | $139 | 156% |
| Veterans Admin - All Plans | $139 | 156% |
| Tricare | $139 | 156% |
| Celtic Comm - All Other Plans | $153 | 172% |
| Blue Cross Blue Shield | $160 | 180% |
| UnitedHealthcare | $266 | 299% |
| Preferred Benefits Admin | $266 | 299% |
| Aetna | $266 | 299% |
| Health Partners - All Plans | $281 | 316% |
| Preferred Hlthcare - All Other Plans | $281 | 316% |
| Healthy Blue Mcaid - All Plans | $296 | 333% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Rooks County Health Center in Plainville, Kansas, the facility's negotiated rates for in-network insurance plans range from $139 to $296, with a median paid amount of $266. This negotiated rate is significantly higher than the facility's cash price of $222, illustrating that paying out-of-pocket can sometimes be more cost-effective for patients with high-deductible plans who have not yet met their insurance coverage thresholds. While the facility is a Critical Access Hospital owned by a government district, the data shows no specific county or state average provided for comparison; however, the stark difference between the cash price and the insurance negotiated rate highlights the importance of verifying your specific plan's allowed amount before scheduling to ensure you are not paying the maximum contract rate.
Patients should be aware that the $266 median paid amount reflects the standard negotiated rate, but asking for a "prompt-pay" discount before check-in could potentially lower this cost if the patient chooses to pay in full upfront. Additionally, because the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should not expect to be billed for the difference between the provider's full charge and the insurance payment. To avoid unexpected costs, it is advisable to request an itemized bill prior to payment to ensure all services are accurately coded and that no unbundled charges or services not rendered are included in the final invoice.