CT scan, neck (cervical spine)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $936
- Cash Discount Price: $685
- vs. Medicare Baseline: 8.76x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 876% of the Medicare baseline (a markup of 776%). 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 |
|---|---|---|
| Healthcare Highways [2210] | $936 | 876% |
| Blue Cross Blue Shield | $936 | 876% |
| Oncology Patient Assistance Programs [2295] | $936 | 876% |
| Web Tpa [2115] | $936 | 876% |
| Aetna | $936 | 876% |
| Black Lung [6055] | $936 | 876% |
| Lucent Health [6000] | $936 | 876% |
| Hooray Health [8000] | $936 | 876% |
| Department Of Corrections [1340] | $1,141 | 1068% |
| Healthpartners [1500] | $1,319 | 1235% |
| National Association Of Letter Carriers [1695] | $1,319 | 1235% |
| American Postal Workers Union [1070] | $1,319 | 1235% |
| Cigna | $1,319 | 1235% |
| Humana | $1,347 | 1261% |
| Multiplan [1680] | $1,773 | 1660% |
| American Healthcare [1055] | $1,773 | 1660% |
| First Health [1375] | $1,773 | 1660% |
| Administrative Concepts [1005] | $1,773 | 1660% |
| Coventry Healthcare [1320] | $1,872 | 1753% |
| Ks Disability Determination [6090] | $2,282 | 2137% |
Consumer Guidance & Cost Commentary
For the CT scan of the neck at the University Of Kansas Health System - St Francis Campus in Topeka, the facility's negotiated rates range from $936 to $2,282 depending on the payer, with a median negotiated amount of $936. This negotiated rate is significantly higher than the cash price of $685, which may offer substantial savings for patients with high-deductible plans who can pay upfront. While the facility's median paid amount of $2,282 matches the gross charge, it is important to note that commercial rates often include administrative overheads that do not apply to cash payments. Patients should explicitly request self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can reduce the total cost by bypassing the costly insurance claims processing cycle.
When evaluating the cost of this procedure, it is crucial to compare the facility's pricing against objective benchmarks rather than the hospital's inflated list prices. The Medicare benchmark for this service is $106.81, which serves as the scientifically validated baseline for the true cost of care. The facility's gross charge of $2,282 represents a markup of 8.8 times the Medicare rate, highlighting the significant difference between commercial billing structures and federal reimbursement standards. To ensure you are not overpaying, always verify your specific plan's allowed amount and consider requesting an itemized billing audit if you receive a summary bill, as over 80% of hospital bills contain errors that can be corrected through a formal dispute.