X-ray, neck (cervical spine)
Facility: Susan B Allen Memorial Hospital
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $554
- Cash Discount Price: $164
- vs. Medicare Baseline: 6.23x 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 623% of the Medicare baseline (a markup of 523%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 394% |
| Providrs Care | $757 | 851% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $164.00, which is significantly lower than the facility's negotiated rates of $554.00 and the commercial payer ranges of $350 to $757. This price difference highlights a key billing principle: for patients with high-deductible plans, paying out-of-pocket can sometimes be more cost-effective than using insurance, as the insurer's negotiated rate often exceeds the cash price. To maximize savings, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing expensive insurance claims processing.
When reviewing your bill, it is crucial to understand that the facility's gross charge of $253.00 is not the final amount you will pay, and comparing it directly to the Medicare amount of $88.91 provides a more accurate view of the facility's markup than looking at the list price alone. While the data does not include a specific county or state average for this procedure, the significant gap between the cash rate and the negotiated rates illustrates how administrative costs and contract dynamics inflate commercial prices. If you receive a bill that seems unexpectedly high, you should request a full itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a formal written dispute.