X-ray, neck (cervical spine)
Facility: Fredonia Regional Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $178
- Cash Discount Price: $198
- vs. Medicare Baseline: 2.00x 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 200% of the Medicare baseline (a markup of 100%). 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 | $98 - $160 | 110% |
| Veterans Programs - All Plans | $101 | 114% |
| UnitedHealthcare | $101 - $178 | 114% |
| Aetna | $101 - $178 | 114% |
| Reserve National-All Plans | $178 | 200% |
| Meritain-All Plans | $178 | 200% |
| Cigna | $178 | 200% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Fredonia Regional Hospital in Kansas, the cash price is $198.00, which matches the facility's median negotiated rate of $178.00 and the cash median. This service is significantly more expensive than the Medicare benchmark of $88.91, reflecting a markup common in commercial billing. While the facility is a Critical Access Hospital with government local ownership, patients should note that cash payment may sometimes be the most cost-effective option if their insurance plan has a high deductible or if the negotiated rate exceeds the cash price. To secure the lowest possible amount, patients are encouraged to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront.
The data shows that while Blue Cross Blue Shield and Veterans Programs have negotiated rates ranging from $98 to $160 and $101 respectively, other payers like UnitedHealthcare and Aetna have ranges extending up to $178. Because commercial rates often include administrative costs and contract dynamics that inflate the baseline price, it is crucial to verify your specific plan's allowed amount before scheduling. If you receive a bill that includes charges for services not rendered, unbundled codes, or items that were cancelled, you should request a full itemized audit rather than accepting a summary bill. Under federal protections like the No Surprises Act, you may also have the right to dispute balance billing for out-of-network services at in-network facilities, ensuring you are not held responsible for unexpected costs.