X-ray, neck (cervical spine)
Facility: Bob Wilson Memorial Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $347
- Cash Discount Price: $170
- vs. Medicare Baseline: 3.90x 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 390% of the Medicare baseline (a markup of 290%). 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 |
|---|---|---|
| Centura Employee Plan | $91 | 102% |
| Aetna | $136 - $340 | 153% |
| Medicare (plans) | $136 | 153% |
| Kansas Health | $136 | 153% |
| Humana | $136 | 153% |
| UnitedHealthcare | $136 - $354 | 153% |
| Blue Cross Blue Shield | $213 | 240% |
| Multiplan | $382 - $395 | 430% |
| Health Partners Of Kansas | $399 | 449% |
| Wppa | $403 | 453% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Bob Wilson Memorial Hospital in Ulysses, Kansas, the facility's cash median price is $170.00, which is significantly lower than the negotiated rates charged to insurance plans ranging from $91 to $403. While the facility is a Critical Access Hospital with a voluntary non-profit, church ownership, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that while the facility offers prompt-pay discounts for upfront payment, patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting the deductible can result in higher out-of-pocket costs than the cash price.
The Medicare benchmark for this service is $88.91, which serves as a reliable baseline for evaluating the facility's pricing markup. The facility's cash rate of $170.00 is approximately 1.9 times the Medicare amount, whereas the median negotiated rate of $347.00 is roughly 3.9 times the Medicare amount, indicating a substantial difference between commercial and government rates. Given that over 80% of hospital bills contain errors, patients should request a detailed, itemized bill rather than accepting a summary invoice to identify any unbundled codes or services not rendered. If a balance bill arises from an out-of-network provider, patients should not pay immediately but instead dispute the charge with their insurer to request a No Surprises Act audit, ensuring they are protected from unexpected costs.