X-ray, neck (cervical spine)
Facility: Aurora Medical Center
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $339
- Cash Discount Price: $340
- vs. Medicare Baseline: 3.81x 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 381% of the Medicare baseline (a markup of 281%). 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 |
|---|---|---|
| Aetna | $200 - $562 | 225% |
| Aurora Caregiver | $240 | 270% |
| Quartz One | $245 | 276% |
| Common Ground | $249 | 280% |
| Everpointe Elite | $259 | 291% |
| Healthpartners | $266 - $510 | 299% |
| Blue Cross Blue Shield | $275 - $578 | 309% |
| Quartz Group | $290 | 326% |
| Hs Technology | $293 | 330% |
| Wisconsin Physician Service | $299 - $315 | 336% |
| Molina Exchange | $308 | 346% |
| Centivo | $328 | 369% |
| UnitedHealthcare | $336 - $573 | 378% |
| Health Payment Systems | $400 | 450% |
| Health Eos Plus | $408 | 459% |
| Trilogy | $410 | 461% |
| Cigna | $460 - $575 | 517% |
| Health Eos | $544 | 612% |
Consumer Guidance & Cost Commentary
Aurora Medical Center, located at 975 Port Washington Road in Grafton, Wisconsin, offers X-ray services for the cervical spine. For this procedure, the facility's cash median rate is $340, while the median negotiated rate for in-network payers is $339. The Medicare benchmark for this service is $88.91, with a commercial-to-Medicare ratio of 3.8. Although the cash price is slightly higher than the negotiated rate, patients with high-deductible plans or those without insurance may find the cash option more cost-effective, as the negotiated rate of $339 exceeds the cash price of $340 only marginally, and the gross chargemaster rate is $680.
To minimize costs, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can provide additional fee reductions for upfront payment. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, unexpected ancillary services or emergency care from out-of-network providers could still trigger balance billing unless disputes are filed. Consumers are advised to request an itemized billing audit before paying, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, when comparing costs, patients should focus on the Medicare rate of $88.91 rather than the inflated gross charges, as this provides a more accurate baseline for evaluating the facility's pricing markup.