X-ray, neck (cervical spine)
Facility: Phillips County Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $247
- Cash Discount Price: $232
- vs. Medicare Baseline: 2.78x 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 278% of the Medicare baseline (a markup of 178%). 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 | $160 - $221 | 180% |
| UnitedHealthcare | $218 - $272 | 245% |
| Health Partners-All Plans | $272 | 306% |
| Medicaid / KanCare | $272 | 306% |
Consumer Guidance & Cost Commentary
For this X-ray of the cervical spine at Phillips County Hospital, the cash price is $232.00, which is lower than the facility's negotiated rates of $247.00 and the highest allowed amount of $272.00 seen for Blue Cross Blue Shield and UnitedHealthcare. While the facility is a Critical Access Hospital in Phillipsburg, KS, with a government-local ownership structure, patients should be aware that paying cash upfront can sometimes result in a lower total cost than using insurance, especially if your plan has a high deductible or if the negotiated rate exceeds the cash price. To secure the best possible price, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full before or shortly after the service.
When reviewing your bill, it is important to distinguish between the facility's gross charge of $272.00 and the actual amounts paid by insurers, which ranged from $160 to $272.00 depending on the plan. Although the data does not provide specific county or state average comparisons for this specific code, understanding that commercial negotiated rates often include administrative overhead can help you evaluate if the final amount is reasonable. If you receive a bill that appears higher than expected, you may be facing balance billing if you are out-of-network, though the No Surprises Act protects you from such charges for emergency care and non-emergency services at in-network facilities. Always request a detailed, itemized bill to verify that no services were unbundled or incorrectly charged before making any payment.