X-ray, neck (cervical spine)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $210
- Cash Discount Price: $221
- vs. Medicare Baseline: 2.36x 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 236% of the Medicare baseline (a markup of 136%). 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 | $177 | 199% |
| Humana | $201 | 226% |
| Aetna | $204 - $221 | 229% |
| Hpk-All Plans | $210 | 236% |
| UnitedHealthcare | $210 | 236% |
| Medicaid / KanCare | $221 | 249% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Medicine Lodge Memorial Hospital, the cash price is $221.00, which matches the facility's negotiated rate for in-network payers like Aetna and UnitedHealthcare. While commercial insurance contracts often result in higher effective costs due to administrative fees and deductible requirements, paying cash directly can sometimes be more economical for patients with high-deductible plans. This facility, a Critical Access Hospital in Medicine Lodge, KS, does not offer a specific self-pay or prompt-pay discount listed in this report, so patients should contact the billing department directly to confirm if any upfront payment incentives are available before scheduling.
The facility's cash rate of $221.00 is significantly higher than the Medicare benchmark of $88.91, reflecting a markup common in commercial pricing structures where rates can average 200% to 300% of the government rate. Because this service is billed at a fixed amount of $221.00 across all payer plans, there is no variation in the allowed amount to trigger balance billing scenarios for out-of-network care. However, patients should always request an itemized bill to ensure no unbundled charges or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.