X-ray, neck (cervical spine)
Facility: Wamego Health Center
Billing Code: 72040 (CPT)
- CPT Billing Code: 72040
- Insurance Median: $49
- Cash Discount Price: $252
- vs. Medicare Baseline: 0.55x 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 |
|---|---|---|
| UnitedHealthcare | $9 - $74 | 10% |
| Aetna | $9 - $77 | 10% |
| Medicaid / KanCare | $9 - $77 | 10% |
| Providrs Care | $14 - $50 | 16% |
| Tricare | $46 | 52% |
| Blue Cross Blue Shield | $210 - $221 | 236% |
Consumer Guidance & Cost Commentary
For the X-ray of the cervical spine at Wamego Health Center, the facility's cash median price is $252.00, which is significantly lower than the negotiated rates commercial insurers typically pay. While UnitedHealthcare, Aetna, and Medicaid/KanCare have negotiated ranges starting as high as $9 to $77 and $9 to $77 respectively, these figures represent the maximum allowed amounts under contract, not the actual cost to the patient. It is important to note that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $252.00 upfront may be more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the negotiated rate exceeds the cash price. Additionally, the facility offers a median negotiated rate of $49.00, which suggests that in-network members may benefit from lower costs once their deductibles are met, though this rate is still subject to specific plan terms.
The facility's pricing is benchmarked against federal standards, with a Medicare amount of $88.91 for this procedure. The cash price of $252.00 is approximately 2.8 times the Medicare rate, reflecting the standard markup for commercial services, while the negotiated rates for major payers generally fall between 50% and 250% of the Medicare amount. Patients should be aware that balance billing is largely prohibited for emergency services and non-emergency care at in-network facilities under the No Surprises Act, meaning they should not expect to be billed for the difference between the chargemaster and the allowed amount if they are covered in-network. To ensure