X-ray, neck (cervical spine)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $160
- Cash Discount Price: $248
- 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 |
|---|---|---|
| Aetna | $53 - $285 | 60% |
| UnitedHealthcare | $66 - $217 | 74% |
| Blue Cross Blue Shield | $160 | 180% |
Consumer Guidance & Cost Commentary
For this X-ray of the cervical spine at Community Memorial Healthcare in Marysville, Kansas, the cash price is $248.00, which matches the facility's median negotiated rate of $160.00 and the state average. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $53 to $285, the cash price remains the lowest option available. This scenario highlights a common billing dynamic where paying out-of-pocket can be more cost-effective than using insurance, especially if your plan has a high deductible or if the insurer's negotiated rate exceeds the cash price. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final cost.
It is important to understand that commercial rates often differ significantly from the Medicare benchmark of $88.91 for this service, with the cash price representing a 1.8x markup over the federal rate. Although the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should remain vigilant regarding balance billing and itemized audits. If you receive a bill that includes unexpected charges from out-of-network ancillary services, you may be protected under the No Surprises Act, which prohibits balance billing for emergency and non-emergency care at in-network facilities. To ensure you are not overcharged, always request a full, itemized CPT-coded bill rather than accepting a summary invoice, and dispute any errors in writing to avoid unnecessary debt.