X-ray, neck (cervical spine)
Facility: Wilson Medical Center
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $254
- Cash Discount Price: $238
- vs. Medicare Baseline: 2.86x 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 286% of the Medicare baseline (a markup of 186%). 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 - $317 | 178% |
| UnitedHealthcare | $168 - $295 | 189% |
| Tricare | $168 | 189% |
| Aetna | $168 - $317 | 189% |
| Humana | $168 | 189% |
| Ambetter / Centene | $168 - $317 | 189% |
| Cigna | $254 | 286% |
| Health Partners-All Plans | $292 | 328% |
| Mulitplan-All Plans | $292 | 328% |
Consumer Guidance & Cost Commentary
For this X-ray of the cervical spine at Wilson Medical Center in Neodesha, KS, the facility's cash price of $238 is lower than the average negotiated rates paid by major insurers like Aetna, Ambetter/Centene, and Blue Cross Blue Shield, which range from $168 to $317. While the facility is a Critical Access Hospital with government ownership, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs than paying cash directly. If you have a high-deductible plan, paying the cash price of $238 upfront may save you money compared to your insurance's negotiated rate, which could exceed the cash amount depending on your specific plan's allowed amount.
To ensure you are not overcharged, always request a prompt-pay discount before scheduling your visit, as hospitals often offer significant reductions for upfront payment that bypass the administrative costs of insurance billing. Additionally, if you receive a bill after an insurance claim, do not accept a summary invoice; instead, demand a full itemized audit to verify that no services were unbundled or double-charged, as over 80% of hospital bills contain errors. Since the facility is in-network for most payers, the No Surprises Act generally protects you from balance billing for emergency or non-emergency services, but you should still verify your specific plan's allowed amount to confirm that the negotiated rate is fair relative to the Medicare benchmark of $88.91.