X-ray, neck (cervical spine)
Facility: Osborne County Memorial Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $215
- Cash Discount Price: $201
- vs. Medicare Baseline: 2.42x 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 242% of the Medicare baseline (a markup of 142%). 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 |
|---|---|---|
| UnitedHealthcare | $180 | 202% |
| Health Partners Of Kansas | $204 | 229% |
| Wppa | $225 | 253% |
| Blue Cross Blue Shield | $232 | 261% |
Consumer Guidance & Cost Commentary
For this X-ray of the cervical spine at Osborne County Memorial Hospital, the cash price of $201.00 is notably lower than the negotiated rates paid by major insurers, which range from $180 to $232 depending on the plan. While the facility's cash rate is competitive, it is important to note that commercial insurance contracts often result in higher out-of-pocket costs for patients who have not yet met their deductible, as the negotiated amounts can exceed the cash price. Given that this facility is a Critical Access Hospital in a rural setting, patients with high-deductible plans may find paying the cash rate directly more beneficial than relying on insurance, provided they confirm their specific plan's coverage limits and any applicable copays.
To ensure you are not overcharged, we recommend requesting an itemized bill that lists every specific CPT code and service rendered, as summary bills often hide unbundled charges or services not received. Additionally, since this facility is locally owned by the government, you should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, which can reduce the final balance by 20% to 50% if paid upfront. When reviewing your statement, compare the allowed amount to the Medicare benchmark of $88.91; if your insurance pays significantly more than this federal rate, it may indicate an inflated negotiated rate that you could potentially negotiate down or bypass by paying cash directly.