X-ray, neck (cervical spine)
Facility: Clara Barton Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $240
- Cash Discount Price: $187
- vs. Medicare Baseline: 2.70x 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 270% of the Medicare baseline (a markup of 170%). 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 | $158 | 178% |
| 6 Degrees Health - All Plans | $187 | 210% |
| Wppa-All Plans | $214 | 241% |
| Phcs - All Plans | $240 | 270% |
| Aetna | $240 | 270% |
| UnitedHealthcare | $240 | 270% |
| Hlth Partners Of Ks-All Plans | $246 | 277% |
Consumer Guidance & Cost Commentary
For this X-ray of the cervical spine at Clara Barton Hospital in Hoisington, KS, the negotiated rates for major insurers like Blue Cross Blue Shield and Aetna range from $158 to $240, while the cash price is $187. This cash rate is notably lower than the facility's negotiated rates, which can be advantageous for patients with high-deductible plans who may not yet have met their out-of-pocket maximums. Although the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should verify their specific plan details, as some commercial payers may negotiate higher rates than the cash price, potentially making self-pay the more economical choice if the insurance allowed amount exceeds the cash rate.
To ensure you are not overcharged, it is critical to request an itemized billing audit before paying any invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, if you receive a balance bill for out-of-network services at this in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency and non-emergency care at in-network hospitals. Finally, consider asking the hospital about prompt-pay discounts, which can reduce the total cost by 20% to 50% if you settle the bill upfront, bypassing the administrative costs associated with insurance claims processing.