X-ray, neck (cervical spine)
Facility: Goodland Regional Medical Center
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $216
- Cash Discount Price: $216
- vs. Medicare Baseline: 2.43x 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 243% of the Medicare baseline (a markup of 143%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $160 | 180% |
| Wppa | $204 - $216 | 229% |
| UnitedHealthcare | $216 | 243% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Goodland Regional Medical Center, the facility's cash price of $216.00 is notably higher than the state of Kansas average, which sits at $160.00. While commercial insurance plans like Blue Cross Blue Shield, Wppa, and UnitedHealthcare have negotiated rates ranging from $160 to $216, these amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurance negotiated ceiling can sometimes be higher than the out-of-pocket cash cost. It is important to verify the specific allowed amount for your plan before scheduling, as in-network rates vary significantly even within the same facility.
To potentially lower your out-of-pocket costs, you should inquire about "self-pay" or "prompt-pay" discounts before check-in, as hospitals often offer fee reductions for upfront payment that bypass the standard insurance billing cycle. Additionally, since the facility is a Critical Access Hospital in Goodland, KS, with a facility rating of 2, comparing the Medicare benchmark of $88.91 against the commercial rates reveals a significant markup; fair pricing is typically defined as 120% to 150% of the Medicare rate, whereas commercial rates here average around 2.4 times the Medicare amount. If you receive a bill, always request a detailed, itemized statement to identify any errors or unbundled codes, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written audit dispute.