X-ray, neck (cervical spine)
Facility: Great Plains Of Sabetha
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $221
- Cash Discount Price: $233
- vs. Medicare Baseline: 2.49x 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 249% of the Medicare baseline (a markup of 149%). 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 |
|---|---|---|
| Celtic Mcr Adv | $121 | 136% |
| Aetna | $122 - $235 | 137% |
| Celtic Comm Exchange-All Other Plans | $151 | 170% |
| Great West Healthcare-All Plans | $198 | 223% |
| UnitedHealthcare | $217 - $233 | 244% |
| Century/Wppa/Providers-All Plans | $221 | 249% |
| Cigna | $221 | 249% |
| Multiplan-Phcs-All Plans | $221 | 249% |
| Humana | $221 | 249% |
| Federated Mutual Ins-All Plans | $224 | 252% |
| Medicaid / KanCare | $233 | 262% |
| Blue Cross Blue Shield | $233 | 262% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Great Plains of Sabetha, the cash price is $233.00, which matches the facility's negotiated rate and the highest amount paid by any payer for this service. While the facility is a Critical Access Hospital in Kansas, the data does not provide specific county or state average figures to compare against. It is important to note that for patients with high-deductible plans, paying the cash price of $233.00 upfront can sometimes be more cost-effective than relying on insurance, as commercial negotiated rates often exceed cash prices due to administrative overhead. Patients should verify if their specific plan has a deductible that would otherwise require them to pay a higher negotiated amount, and they should ask the hospital directly about "self-pay" or "prompt-pay" discounts that could further reduce the cost.
The Medicare benchmark for this procedure is $88.91, which serves as a baseline for evaluating the facility's pricing markup. The facility's cash rate of $233.00 represents a 2.5x multiplier compared to the Medicare amount, reflecting the standard commercial pricing structure where rates often average 200% to 300% of Medicare. If you are reviewing an itemized bill, ensure you are not paying for bundled services separately or for items that were never rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit. Always request a full itemized CPT-coded statement before finalizing payment to identify any unbundled codes or services not rendered, and remember that federal protections under the No Surprises Act may prevent balance billing for out-of-network services at in-network facilities.