X-ray, neck (cervical spine)
Facility: Children'S Mercy South
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $25
- Cash Discount Price: $153
- vs. Medicare Baseline: 0.28x 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.
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 |
|---|---|---|
| UnitedHealthcare | $9 - $407 | 10% |
| Cigna | $10 - $421 | 11% |
| Healthy Blue | $10 - $226 | 11% |
| Medicaid / KanCare | $10 - $57 | 11% |
| Home State Health | $10 - $198 | 11% |
| Healthlink | $14 - $533 | 16% |
| Wppa Providrs Care | $14 - $394 | 16% |
| Quiktrip | $15 - $395 | 17% |
| Health Midwest Comprehensive Care | $15 - $395 | 17% |
| American Healthcare Alliance | $15 - $515 | 17% |
| Blue Cross Blue Shield | $16 - $448 | 18% |
| Multiplan | $19 - $461 | 21% |
| Medica | $19 - $353 | 21% |
| Aetna | $20 - $412 | 22% |
| Wellfit/Centrus | $20 - $394 | 22% |
| Humana | $21 - $403 | 24% |
| Centivo | $21 - $394 | 24% |
| Nebraska Furniture Mart | $21 - $394 | 24% |
| Orscheln | $22 - $394 | 25% |
| Mercy Health | $23 - $454 | 26% |
| Coxhealth Network | $24 - $448 | 27% |
| Coventry Health Care Of Kansas | $25 - $448 | 28% |
| National Preferred Provider Network | $28 - $545 | 31% |
Consumer Guidance & Cost Commentary
For this X-ray of the cervical spine at Children's Mercy South in Overland Park, the cash price is $153, which is significantly lower than the facility's gross charge of $319. While the facility is a voluntary non-profit, the negotiated rates for in-network insurance plans vary widely, ranging from $9 to $545 depending on the carrier. Notably, the cash price of $153 is lower than the Medicare benchmark of $88.91 when adjusted for the facility's specific rate structure, though it remains below the median negotiated rate of $25 reported for this service type. Patients with high-deductible plans may find paying the cash price upfront more cost-effective than relying on insurance, as the negotiated rates for many payers exceed the cash amount, potentially leaving the patient responsible for higher out-of-pocket costs if their deductible is not yet met.
To avoid unexpected balance billing, patients should verify their insurance status before scheduling, as the No Surprises Act protects against surprise bills for out-of-network services at in-network facilities. If a patient receives a bill for the difference between the provider's full charge and the insurance allowed amount, they should request an itemized audit to identify errors or unbundled codes, as over 80% of hospital bills contain inaccuracies. Additionally, patients should explicitly ask about prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid in full within 30 days, bypassing the administrative costs associated with insurance claims processing. Always confirm whether the facility offers a self-pay rate before check-in to ensure you are not inadvertently enrolled in a billing cycle that results in higher costs.