CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Lafayette Regional Health Center

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $383
  • Cash Discount Price: $912
  • vs. Medicare Baseline: 4.31x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Lafayette Regional Health Center is $383. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $912. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 4.31x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$912

Average discount available for prompt cash payment at this facility.

Insurance Median
$383

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$88.91

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $88.91 (100%)
Cash / Self-Pay: $912 (1026%)
Insurance Median: $383 (431%)
Cash: $912 (1026% of Medicare)
Ins. Median: $383 (431% of 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 431% of the Medicare baseline (a markup of 331%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Corvel Corporation $35 - $775 39%
Oha Network $36 - $456 40%
United $49 - $410 55%
Healthyblue $50 56%
Medicaid / KanCare $50 56%
Aetna $51 - $798 57%
Amerigroup $51 57%
Home State Health Plan $51 57%
Unicare $51 57%
Ambetter / Centene $170 191%
Nhc Advantage $173 195%
Universal Healthcare $237 267%
Humana $308 - $392 346%
Blue Cross Blue Shield $347 - $912 390%
College Park Family Care Center $392 441%
Oscar $456 513%
Cigna $521 - $651 586%
Wppa Providrs Care Network $684 769%
Multiplan $712 801%
Coventry $728 819%
Coventry Kc Mo $728 819%
Cco, Inc. $775 872%
Focus Healthcare Mgmt, Inc $821 923%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals