X-ray, neck (cervical spine)
Facility: F W Huston Medical Center
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $361
- Cash Discount Price: $375
- vs. Medicare Baseline: 4.06x 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 406% of the Medicare baseline (a markup of 306%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $160 | 180% |
| Aetna | $352 | 396% |
| Humana | $371 | 417% |
| Cigna | $399 | 449% |
Consumer Guidance & Cost Commentary
For the X-ray of the neck (cervical spine) at F W Huston Medical Center in Winchester, KS, the facility's cash median price is $375.00, which is lower than the negotiated rates charged to in-network insurers like Blue Cross Blue Shield ($160), Aetna ($352), and Humana ($371). While commercial insurance contracts often set a ceiling on what payers will cover, patients with high-deductible plans may find paying the cash price directly more affordable if their insurance allowed amount exceeds this figure. It is important to note that while the facility is a Critical Access Hospital, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final cost by bypassing administrative processing fees.
The facility's negotiated rates average $361.00, which is slightly lower than the cash median, but significantly higher than the Medicare benchmark of $88.91 for this procedure. This comparison highlights that commercial rates often include administrative overhead and contract dynamics that push prices well above the federal government's calculated "true cost" of care. To ensure you are not overcharged, you should request an itemized billing audit if you receive a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or charges for services not rendered. If you encounter a balance bill from an out-of-network provider, remember that the No Surprises Act protects you from paying the difference between the provider's full list price and your insurance's allowed amount for emergency or non-emergency services at in-network facilities.