X-ray, neck (cervical spine)
Facility: Lincoln County Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $160
- Cash Discount Price: $201
- vs. Medicare Baseline: 1.80x 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 |
|---|---|---|
| Blue Cross Blue Shield | $160 | 180% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Lincoln County Hospital in Lincoln, KS, the facility's cash price of $201.00 is notably higher than the state average for this service. While the hospital is a government-owned Critical Access Hospital, the negotiated rate for in-network patients is $160.00, which aligns with the lowest and highest reported rates from Blue Cross Blue Shield. This suggests that for this specific payer, the negotiated rate is the standard expected cost. However, patients should be aware that commercial negotiated rates often include administrative overhead and contract premiums, meaning the actual cost to a patient with high-deductible insurance could be lower if they pay cash directly, provided the insurance allowed amount exceeds the cash price.
To ensure you are not overpaying, it is crucial to verify your specific plan's allowed amount before scheduling, as in-network rates can vary significantly between facilities. If you choose to pay out-of-pocket, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the $201.00 cash price by 20% to 50% if settled upfront. Additionally, since the facility's gross charge is $224.00, you should request an itemized bill to confirm no unbundled codes or services not rendered are included. Always compare the final cost against the Medicare benchmark of $88.91; commercial rates are often marked up significantly above this federal baseline, so understanding the difference between the gross charge, the negotiated rate, and the cash price is essential for accurate financial planning.