X-ray, neck (cervical spine)
Facility: Graham County Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $167
- Cash Discount Price: $215
- vs. Medicare Baseline: 1.88x 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.
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 | $118 | 133% |
| UnitedHealthcare | $118 - $204 | 133% |
| Blue Cross Blue Shield | $158 | 178% |
| Medicare (plans) | $161 | 181% |
| Celtic Commercial-All Other Plans | $177 | 199% |
| Wppa (Providers Care)-All Plans | $204 | 229% |
Consumer Guidance & Cost Commentary
For this X-ray of the cervical spine at Graham County Hospital in Hill City, Kansas, the cash price is $215.00, which matches the facility's median negotiated rate. While commercial payers like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $118 to $204, the cash price remains the same as the Medicare benchmark of $88.91 multiplied by a factor of 1.9. This indicates that paying out-of-pocket directly is not the most cost-effective option for those with insurance, as the negotiated rates are generally lower than the cash price. However, patients with high-deductible plans should verify their specific deductible status before scheduling, as paying the full negotiated amount upfront could be more expensive than waiting for insurance to cover the service once the deductible is met.
It is important to note that while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, unexpected charges can still arise from out-of-network ancillary services like emergency physicians or lab tests. If you receive a bill that seems higher than expected, request a formal itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors. Additionally, you should ask the hospital about prompt-pay discounts, which can reduce the total cost by 20% to 50% if paid in full within a short window, effectively bypassing the administrative costs associated with insurance claims processing. Always confirm your plan's network status and request self-pay pricing before your appointment to ensure you are aware of all potential costs.