X-ray, neck (cervical spine)
Facility: Morris County Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $202
- Cash Discount Price: $310
- vs. Medicare Baseline: 2.27x 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 227% of the Medicare baseline (a markup of 127%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $31 | 35% |
| Blue Cross Blue Shield | $152 - $202 | 171% |
| Choice Care Mcr Adv-All Plans | $202 | 227% |
| UnitedHealthcare | $202 - $517 | 227% |
| Va Ccn-All Plans | $202 | 227% |
| Coventry Mcr | $202 | 227% |
| Cigna | $374 | 421% |
| Aetna | $463 | 521% |
| Coventry Comm-All Other Plans | $465 | 523% |
| Multiplan-All Plans | $465 | 523% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Morris County Hospital in Council Grove, Kansas, the facility's cash median rate is $310.00, which is notably lower than the negotiated rates paid by most major insurers. While commercial payers like Blue Cross Blue Shield and UnitedHealthcare have negotiated rates ranging from $152 to $517, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds this figure. It is important to note that while the facility is a Critical Access Hospital with government local ownership, the cash rate does not automatically apply to insured patients; however, asking for a "self-pay" or "prompt-pay" discount before scheduling can often reduce the final bill, as hospitals frequently offer fee reductions for upfront payment to bypass costly administrative processing.
The Medicare benchmark for this service is $88.91, which serves as a scientifically validated baseline for the true cost of care, revealing that commercial negotiated rates often include significant markups due to administrative overhead and contract dynamics. Although the data provided does not include specific county or state average comparisons for this procedure, the disparity between the Medicare rate and the cash price highlights the potential for substantial savings when paying directly. Consumers should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but it is crucial to verify network status and request an itemized bill to ensure no unexpected charges are incurred.