X-ray, neck (cervical spine)
Facility: Kiowa District Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $297
- Cash Discount Price: $251
- vs. Medicare Baseline: 3.34x 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 334% of the Medicare baseline (a markup of 234%). 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 |
|---|---|---|
| Tricare | $122 | 137% |
| Blue Cross Blue Shield | $158 | 178% |
| Healthchoice-All Plans | $160 | 180% |
| UnitedHealthcare | $251 - $314 | 282% |
| Health Partners Of Ks-All Plans | $276 | 310% |
| Humana | $283 | 318% |
| Gbs Insurance - All Plans | $295 | 332% |
| Multiplan-All Plans | $295 | 332% |
| Triwest-All Plans | $298 | 335% |
| Medicare (plans) | $298 | 335% |
| Aetna | $298 | 335% |
| Medicaid / KanCare | $314 | 353% |
| Providers Care (Wppa)-All Plans | $471 | 530% |
| Liberty Healthshare-All Plans | $507 | 570% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Kiowa District Hospital in Kiowa, KS, the cash price is $251.00, which is lower than the facility's negotiated rates with most major insurers. While the facility's cash rate is significantly lower than the gross charge of $314.00, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs due to administrative fees and contract structures. For instance, UnitedHealthcare's negotiated range spans from $251.00 to $314.00, and Providers Care (Wppa) has a negotiated rate of $471.00, which exceeds the cash price. If a patient has a high-deductible plan or has not yet met their deductible, paying the cash price of $251.00 upfront may be more financially advantageous than relying on insurance, which could lead to balance billing if the allowed amount exceeds the patient's coverage limits.
To ensure the most favorable pricing, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% for upfront payment. It is also important to compare these rates against the Medicare benchmark of $88.91, which serves as the objective baseline for hospital pricing; commercial negotiated rates typically average 200% to 300% of this Medicare amount, whereas fair pricing is often defined as 120% to 150%. Given that this facility is a Critical Access Hospital in a rural setting, the cash rate of $251.00 represents a transparent, non-negotiable