X-ray, neck (cervical spine)
Facility: Memorial Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $358
- Cash Discount Price: $651
- vs. Medicare Baseline: 4.03x 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 403% of the Medicare baseline (a markup of 303%). 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 | $169 | 190% |
| Humana | $326 | 367% |
| Tricare | $326 | 367% |
| Medicare (plans) | $329 | 370% |
| Ambetter / Centene | $358 | 403% |
| Coventry - All Other Plans | $586 | 659% |
| Preferred Healthcare-All Plans | $619 | 696% |
| Health Partners Of Kansas - All Plans | $619 | 696% |
| Wppa/Providers Care-All Plans | $912 | 1026% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Memorial Hospital in Abilene, KS, the cash price is $651.00, which matches the facility's median paid amount. While commercial insurance plans typically negotiate rates between $169 and $912 depending on the carrier, the cash price is notably lower than the median negotiated rate of $358.00 reported for this service. Patients with high-deductible plans may find paying out-of-pocket directly cheaper than using insurance, as the cash price avoids the administrative markup and potential out-of-pocket maximums associated with commercial billing. It is advisable to confirm with the hospital whether "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can further reduce the final cost.
This facility operates as a Critical Access Hospital in Abilene, and its pricing structure reflects standard billing practices where cash rates often diverge from insurance allowed amounts. Although the data provided does not include specific county or state average comparisons for this CPT code, the Medicare benchmark rate of $88.91 serves as a clear baseline for evaluating the facility's pricing. Commercial rates, which average 200% to 300% of Medicare, can sometimes exceed the cash price, making direct payment a strategic option for those without immediate insurance coverage. Consumers should always request an itemized bill to verify charges and avoid balance billing, particularly if receiving care from out-of-network providers, as federal protections under the No Surprises Act may limit unexpected costs for emergency and non-emergency services.