CMS Price Transparency Data

X-ray, neck (cervical spine)

Facility: Pawhuska Hospital, Inc

Billing Code: 72040 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72040
  • Insurance Median: $257
  • Cash Discount Price: $203
  • vs. Medicare Baseline: 2.89x Medicare
The contracted insurance negotiated median rate for a X-ray, neck (cervical spine) at Pawhuska Hospital, Inc is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $203. Compared to the federal Medicare reimbursement reference rate of $88.91, this hospital’s rate is 2.89x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.
Cash / Self-Pay
$203

Average discount available for prompt cash payment at this facility.

Insurance Median
$257

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: $203 (228%)
Insurance Median: $257 (289%)
Cash: $203 (228% of Medicare)
Ins. Median: $257 (289% 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 289% of the Medicare baseline (a markup of 189%). 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
Healthchoice Ip/Op Only - All Plans $180 202%
Blue Cross Blue Shield $183 - $298 206%
Aetna $203 - $350 228%
Tricare $203 228%
UnitedHealthcare $203 - $252 228%
Wellcare Mcr Adv - All Plans $203 228%
Humana $205 - $350 231%
Community Care Comm - All Plans $222 250%
Healthcare Highways - All Plans $228 256%
Cigna $238 268%
Multiplan - All Plans $262 295%
Ambetter / Centene $304 342%
Preferred Commchoice Ip/Op Only - All Plans $315 354%
Soonerselect Mcaid - All Plans $350 394%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1101 East 15Th Street, Pawhuska, OK 74056
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals