X-ray, neck (cervical spine)
Facility: Smith County Memorial Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $231
- Cash Discount Price: $245
- vs. Medicare Baseline: 2.60x 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 260% of the Medicare baseline (a markup of 160%). 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 | $158 | 178% |
| Medicaid / KanCare | $172 - $245 | 193% |
| Multiplan-All Plans | $221 | 249% |
| Wppa-All Plans | $231 | 260% |
| Health Partners Of Ks Ppo-All Plans | $233 | 262% |
| UnitedHealthcare | $233 | 262% |
| Midlands Choice-All Plans | $233 | 262% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Smith County Memorial Hospital in Smith Center, KS, the cash price is $245.00, which matches the facility's gross charge and the median amount paid by insurance. This rate is significantly higher than the Medicare benchmark of $88.91, indicating a markup of 2.6 times the federal baseline. While commercial insurance plans like Medicaid/KanCare and Blue Cross Blue Shield negotiate rates ranging from $158 to $245, these negotiated amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the full cash price of $245.00 directly, as this avoids the administrative overhead and potential higher negotiated rates that insurers apply to covered services.
To ensure you are receiving the most accurate pricing, it is important to distinguish between summary bills and detailed itemized statements. Hospitals may issue broad category totals that obscure individual costs, so requesting a full CPT-coded itemized bill is essential to identify any unbundled charges or services not rendered. Additionally, since this facility is a Critical Access Hospital with government local ownership, you should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling your visit. These discounts, which can range from 20% to 50%, are offered to patients who pay upfront and bypass the costly insurance claims process, potentially reducing your final bill below the listed cash price.