X-ray, neck (cervical spine)
Facility: Sheridan County Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $220
- Cash Discount Price: $297
- vs. Medicare Baseline: 2.47x 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 247% of the Medicare baseline (a markup of 147%). 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 Insurance | $180 | 202% |
| Blue Cross Blue Shield | $220 | 247% |
| UnitedHealthcare | $282 | 317% |
Consumer Guidance & Cost Commentary
For this X-ray of the cervical spine at Sheridan County Hospital in Hoxie, KS, the cash price is $297.00, which matches the facility's median paid amount. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rates for major payers like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare range from $180 to $282. Notably, the cash price is identical to the highest negotiated rate offered by UnitedHealthcare, meaning patients with high-deductible plans might save money by paying cash directly rather than relying on insurance, provided they can afford the upfront cost. Since the facility is in-network for these carriers, the No Surprises Act protects patients from balance billing for this service, ensuring they are not billed the difference between the chargemaster and the insurance allowed amount.
To ensure you receive the best possible price, we recommend requesting a prompt-pay discount before scheduling your visit, as hospitals often offer 20% to 50% reductions for upfront payment to bypass administrative claim processing costs. Additionally, always ask for a full itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. For context, this service is priced at 2.5 times the Medicare benchmark of $88.91, which serves as the objective baseline for fair pricing. If you have received a bill, dispute any discrepancies in writing to the billing supervisor to avoid unexpected debt, and verify your deductible status before using insurance to ensure you are not paying out-of-pocket for services covered by your plan.