X-ray, neck (cervical spine)
Facility: Minneola District Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $190
- Cash Discount Price: $112
- vs. Medicare Baseline: 2.14x 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 214% of the Medicare baseline (a markup of 114%). 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 |
|---|---|---|
| Va Community Care Program-All Plans | $10 - $168 | 11% |
| UnitedHealthcare | $10 - $250 | 11% |
| Humana | $10 - $168 | 11% |
| Medicaid / KanCare | $31 - $250 | 35% |
| Aetna | $31 - $250 | 35% |
| Providrs Care Network-All Plans | $31 - $212 | 35% |
| Blue Cross Blue Shield | $160 | 180% |
| Corporate Plan Management-All Plans | $212 | 238% |
| Preferred Health Care (Coventry)-All Other Plans | $225 | 253% |
| Triwest-All Plans | $225 | 253% |
| Health Partners Of Kansas-All Plans | $238 | 268% |
| Phc (Coventry) Leased Network | $238 | 268% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Minneola District Hospital, the cash price is $112.00, which is lower than the facility's negotiated rate of $225.00 and the state average of $190.00. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates up to $250.00, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket and seeking prompt-pay discounts. Because commercial rates include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40%, it is advisable to verify the allowed amount before scheduling to ensure you are not paying more than necessary.
The facility's Medicare benchmark rate is $88.91, which serves as a reliable baseline for evaluating pricing fairness, as commercial negotiated rates typically average 200% to 300% of this figure. Although the facility is a government-owned Critical Access Hospital, the negotiated rates for this service range from $10.00 to $250.00 across 12 different payers, with the highest rates reaching $238.00 for certain networks. To avoid unexpected costs, patients should request a self-pay or prompt-pay discount before check-in and ensure a waiver of insurance submission is signed to bypass automatic claims processing, which can void cash agreements. Always review the itemized bill for errors, as over 80% of hospital bills contain mistakes that can be corrected through a formal audit dispute.