X-ray, neck (cervical spine)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $219
- Cash Discount Price: $225
- vs. Medicare Baseline: 2.46x 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 246% of the Medicare baseline (a markup of 146%). 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 |
|---|---|---|
| Humana | $130 | 146% |
| Tricare | $140 | 157% |
| Aetna | $164 - $238 | 184% |
| Va Ccn - All Plans | $164 | 184% |
| UnitedHealthcare | $164 - $265 | 184% |
| Medicaid / KanCare | $164 - $265 | 184% |
| Ambetter / Centene | $181 | 204% |
| Blue Cross Blue Shield | $219 | 246% |
| Health Partners - All Plans | $252 | 283% |
| Healthy Blue Mcaid - All Plans | $265 | 298% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Trego County Lemke Memorial Hospital, the cash price is $225.00, which is lower than the median negotiated rate of $219.00 paid by most insurers. While the facility's cash rate is competitive, patients with high-deductible plans might find it beneficial to pay the cash price directly if their insurance negotiated rate exceeds this amount, as the cash price often serves as a baseline for potential discounts. It is important to note that the facility is a Critical Access Hospital in Wakeeney, KS, and while specific county or state average data was not provided in the report, the cash rate of $225.00 represents a significant portion of the gross charge of $265.00, suggesting that paying out-of-pocket could result in immediate savings compared to the full chargemaster.
Patients should be aware that commercial insurance rates can sometimes exceed cash prices due to administrative costs and contract dynamics, meaning that paying directly might be the most cost-effective option for those without insurance or with limited coverage. Before scheduling, it is advisable to explicitly request "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, effectively bypassing the higher administrative fees associated with insurance billing. Additionally, if you receive a bill after using insurance, ensure you request a detailed, itemized statement to verify that no balance billing or unbundled charges are included, as federal protections like the No Surprises Act may prevent surprise bills for emergency or non-emergency services at in-network facilities.