CT scan, neck (cervical spine)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $105
- Cash Discount Price: $1,836
- vs. Medicare Baseline: 0.98x 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 $106.81 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 |
|---|---|---|
| Medicaid / KanCare | $60 - $104 | 56% |
| Blue Cross Blue Shield | $60 - $578 | 56% |
| Humana | $72 - $102 | 67% |
| Aetna | $72 - $2,400 | 67% |
| UnitedHealthcare | $91 - $1,903 | 85% |
| Medicare (plans) | $102 - $106 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $102 | 95% |
| Halo Hcr Inc Hospice [20432] | $102 | 95% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $102 | 95% |
| Kindful Hospice Contracted [320434] | $102 | 95% |
| Mercy Hospice Okc [20252] | $102 | 95% |
| Elara Caring Aspire Hospice [20433] | $102 | 95% |
| Kindful Hospice [20434] | $102 | 95% |
| Cross Timbers Hospice [20098] | $102 | 95% |
| Pace Of The Ozarks Contracted [320518] | $102 | 95% |
| Tricare | $102 | 95% |
| Dept Of Veteran Affairs Contracted [320106] | $102 | 95% |
| Home State Health Plan Contracted [320187] | $104 | 97% |
| Ambetter / Centene | $104 | 97% |
| Providrs Care Network Contracted [320484] | $197 | 184% |
| Health Choice Contracted [320166] | $239 | 224% |
| Cigna | $455 - $467 | 426% |
| Medica Contracted [320239] | $734 | 687% |
| United Medical Resources Contracted [320454] | $1,903 | 1782% |
| Imagine 360 Contracted [320494] | $2,259 | 2115% |
| Aither Health Contracted [320449] | $2,259 | 2115% |
| Healthlink Contracted [320179] | $2,259 | 2115% |
| Ebms Contracted [320493] | $2,259 | 2115% |
| Edison Health Solutions Contracted [320502] | $2,259 | 2115% |
| Mercy Benefit Admin Contracted [320251] | $2,259 | 2115% |
| Workers Comp [20426] | $2,259 | 2115% |
| American Healthcare Alliance Contracted [320020] | $2,259 | 2115% |
| Reflect Health Contracted [320492] | $2,259 | 2115% |
| Auxiant Contracted [320462] | $2,259 | 2115% |
| Yuzu Health Contracted [320521] | $2,259 | 2115% |
| First Health Contracted [320128] | $2,400 | 2247% |
Consumer Guidance & Cost Commentary
For the CPT code 72125, representing a CT scan of the cervical spine, Mercy Hospital Pittsburg, Inc. lists a gross charge of $2,824.00. While the facility offers a cash median price of $1,836.00, which is lower than the gross charge, patients should be aware that many commercial payers negotiate rates significantly higher than the cash price. For instance, UnitedHealthcare, Aetna, and several other insurers have negotiated rates ranging from $72 to $2,400, often exceeding the cash amount. Because commercial negotiated rates can sometimes be higher than the cash price, patients with high-deductible plans may find it financially advantageous to pay the cash median directly, provided they secure a "self-pay" or "prompt-pay" discount before scheduling.
The facility's pricing structure is heavily influenced by its network status and contract types. Medicare plans are billed a fixed rate of $106.81, while numerous hospice contracts and workers' compensation plans are set at $102.00 or $2,259.00, reflecting the specific administrative and service agreements for those payers. It is important to note that balance billing is generally prohibited for emergency services at in-network facilities under the No Surprises Act, though patients should verify their specific plan details to avoid unexpected out-of-pocket costs. To ensure the most accurate pricing, consumers are advised to request an itemized bill to review all CPT codes and avoid summary bills that may obscure individual charges, and to confirm their deductible status before proceeding with any treatment.