X-ray, neck (cervical spine)
Facility: Ellsworth County Medical Center
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $181
- Cash Discount Price: $201
- vs. Medicare Baseline: 2.04x 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 204% of the Medicare baseline (a markup of 104%). 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 |
|---|---|---|
| Triwest -All Plans | $94 | 106% |
| Healthy Blue Mcr Adv | $94 | 106% |
| Va Ccn-All Plans | $94 | 106% |
| Humana | $94 - $191 | 106% |
| UnitedHealthcare | $131 - $201 | 147% |
| Blue Cross Blue Shield | $150 - $158 | 169% |
| Aetna | $181 | 204% |
| First Health - All Plans | $181 | 204% |
| Cigna | $191 | 215% |
| Healthy Blue Mcaid- All Other Plans | $201 | 226% |
| Medicaid / KanCare | $201 | 226% |
| Coventry Mcaid-All Plans | $201 | 226% |
| Providers Care-Wppa-All Plans | $302 | 340% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Ellsworth County Medical Center, the cash price is $201.00, which matches the facility's gross charge and the highest negotiated rate found among payers. This cash rate is significantly higher than the state average, which is approximately $88.91 based on Medicare benchmarks. While commercial insurance contracts often cap payments at negotiated rates, these amounts can exceed cash prices due to administrative overhead and contract dynamics. For patients with high-deductible plans where the deductible has not yet been met, paying the cash price of $201.00 upfront may be more cost-effective than relying on insurance, which could result in a higher allowed amount or out-of-pocket liability if the deductible is not satisfied.
To minimize costs, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these programs can reduce bills by 20% to 50% for upfront payment. It is also important to request an itemized bill to ensure no errors exist, as over 80% of hospital bills contain discrepancies such as double-billing or unbundled codes. Finally, when comparing prices, focus on the Medicare benchmark of $88.91 rather than the hospital's gross chargemaster, as this provides a scientifically validated baseline for fair pricing. Always confirm your specific plan's deductible status and allowed amounts with the billing department to avoid unexpected financial surprises.