X-ray, neck (cervical spine)
Facility: Stanton County Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $339
- Cash Discount Price: $357
- vs. Medicare Baseline: 3.81x 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 381% of the Medicare baseline (a markup of 281%). 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 | $152 - $339 | 171% |
| Healthy Blue Mcr Adv - All Other Plans | $350 | 394% |
| Healthy Blue Mcaid | $357 | 402% |
Consumer Guidance & Cost Commentary
For the CPT code 72040, representing an X-ray of the cervical spine, Stanton County Hospital in Johnson, KS, lists a cash median price of $357.00. This cash rate aligns exactly with the facility's gross charge and the median amount paid by insurers, suggesting that for patients with high-deductible plans, paying out-of-pocket may be the most cost-effective option if the insurance negotiated rate exceeds this amount. While the facility is a Critical Access Hospital owned by the local government, the specific negotiated rates for this procedure range from $152 to $357 across three payers, with the lowest negotiated amount of $152 significantly lower than the cash price. However, patients should be aware that commercial insurance contracts often include administrative overheads that can inflate the baseline price, and the median negotiated rate of $345.00 is only slightly lower than the cash price, indicating limited savings from using insurance for this specific service.
To ensure you are receiving the best possible rate, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Since the facility is a Critical Access Hospital, you should also inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing costly insurance claims processing. Additionally, while the Medicare benchmark for this service is $88.91, commercial rates are often marked up significantly above this federal baseline; however, the data shows a median negotiated rate of $339.00