X-ray, neck (cervical spine)
Facility: Republic County Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $319
- Cash Discount Price: $260
- vs. Medicare Baseline: 3.59x 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 359% of the Medicare baseline (a markup of 259%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $295 | 332% |
| Aetna | $312 | 351% |
| Meritain-All Plans | $312 | 351% |
| UnitedHealthcare | $319 | 359% |
| Midlands Choice-All Plans | $330 | 371% |
| Cigna | $330 | 371% |
| First Health-All Plans | $330 | 371% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Republic County Hospital in Belleville, KS, the commercial negotiated rate is $319, which matches the median paid amount across all seven insurance plans. This rate is significantly higher than the cash price of $260, illustrating that using insurance can sometimes cost more than paying out-of-pocket. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should verify if their specific plan has a high deductible, as paying the full cash price of $260 upfront may be more financially advantageous than the $319 negotiated rate if the insurance coverage has not yet covered the deductible.
The Medicare benchmark for this service is $88.91, serving as the objective baseline for evaluating pricing markups. The commercial negotiated rate of $319 represents approximately 360% of the Medicare amount, which is well above the typical fair pricing range of 120% to 150% of the Medicare rate. To potentially lower costs, patients should inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these programs often offer fee reductions for upfront payment. Additionally, since the facility is located in a specific geographic area, it is important to ensure that any negotiated rates are adjusted according to local wage indexes to reflect true cost baselines rather than inflated chargemaster lists.