X-ray, neck (cervical spine)
Facility: Oakleaf Surgical Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $86
- Cash Discount Price: $261
- vs. Medicare Baseline: 0.97x 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 |
|---|---|---|
| Blue Cross Blue Shield | $86 | 97% |
| Dean Health Plan | $86 | 97% |
| Group Health Cooperative Of Eau Claire | $86 | 97% |
| Healthpartners | $86 | 97% |
| Humana | $86 | 97% |
| Medica | $86 | 97% |
| Quartz Health Solutions | $86 | 97% |
| Security Health Plan Of Wi | $86 - $876 | 97% |
| Ucare Wi | $86 | 97% |
| UnitedHealthcare | $86 | 97% |
| Alliance | $216 | 243% |
Consumer Guidance & Cost Commentary
For patients paying cash or self-pay, the most important takeaway is that upfront payment offers the lowest possible price for this cervical spine X-ray procedure. The facility lists a cash median rate of $261, which represents the standard self-pay amount. Because insurance claims involve administrative processing and negotiated markups, paying this amount directly can be significantly cheaper than what many commercial payers are willing to pay through their benefits.
In the broader pricing context, this cash rate of $261 is lower than the facility's median negotiated rate of $86 and the gross charge of $290, though it remains higher than the Medicare benchmark of $88.91. When comparing to regional standards, the cash rate is notably lower than the state average of $239 for this specific service. Patients are encouraged to verify if their specific insurance plan has a negotiated rate of $86 or higher, as paying the cash price of $261 might still result in a net savings if their deductible has not yet been met or if the insurer's allowed amount exceeds the cash rate. Always ask the billing department about prompt-pay discounts before scheduling to ensure you are receiving the most favorable financial terms available.