X-ray, neck (cervical spine)
Facility: St Luke Hospital & Living Center
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $176
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.98x 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.
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 |
|---|---|---|
| Va Ccn | $176 | 198% |
| Humana | $176 | 198% |
| Bluestem Pace | $176 | 198% |
| Kansas Department Of Health And Environment | $176 | 198% |
| Blue Cross Blue Shield | $176 | 198% |
| UnitedHealthcare | $176 | 198% |
| Ambetter / Centene | $178 | 200% |
Consumer Guidance & Cost Commentary
For this X-ray of the cervical spine at St Luke Hospital & Living Center in Marion, KS, the negotiated rate is $176, which matches the lowest and highest amounts paid by all seven commercial payers listed, including UnitedHealthcare and Blue Cross Blue Shield. This facility is a Critical Access Hospital with government ownership, and while the data does not provide a specific cash or median paid amount, the negotiated rate is 2.0 times the Medicare benchmark of $88.91. When comparing pricing, it is important to note that cash payments can sometimes be cheaper for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price, so patients should always ask the hospital about self-pay or prompt-pay discounts before scheduling.
Because this service is billed through commercial contracts, the $176 rate represents a ceiling that protects in-network members from the full chargemaster gross of $346, but it may still be higher than the true cost of care. Patients should be aware that hospitals often issue summary bills that obscure individual line items, so requesting a full itemized CPT-coded statement is the most effective way to identify errors, unbundled codes, or services not rendered. If a patient receives a balance bill for the difference between the negotiated rate and the allowed amount, they should verify the legality of the charge under the No Surprises Act, particularly if the care was provided at an in-network facility, and dispute any unexpected bills in writing rather than accepting summary invoices as final.