CT scan, neck (cervical spine)
Facility: St. Catherine Hospital - Garden City
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $383
- Cash Discount Price: $1,700
- vs. Medicare Baseline: 3.59x 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 359% of the Medicare baseline (a markup of 259%). 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 |
|---|---|---|
| Medicare (plans) | $73 - $85 | 68% |
| Humana | $73 - $85 | 68% |
| Aetna | $73 - $2,300 | 68% |
| Kansas Health | $73 | 68% |
| Cigna | $73 - $310 | 68% |
| UnitedHealthcare | $73 - $1,692 | 68% |
| Blue Cross Blue Shield | $73 - $569 | 68% |
| Kaiser | $73 - $1,589 | 68% |
| Innovage | $85 | 80% |
| Devoted Health | $85 | 80% |
| United Colorado Doctor'S Plan | $245 | 229% |
| Direct To Employer | $322 - $2,307 | 301% |
| Centura Employee Plan | $337 | 316% |
| Peak Health | $433 - $2,249 | 405% |
| Multiplan | $592 - $4,902 | 554% |
| Denver Health | $1,361 | 1274% |
| Wpaa | $1,913 | 1791% |
| Christian Health Aid | $2,187 | 2048% |
| Health Partners Of Kansas | $2,651 | 2482% |
Consumer Guidance & Cost Commentary
For patients paying out-of-pocket, the most important fact is that the cash median price for this CT scan is $1,700. While commercial insurance typically negotiates higher rates due to administrative overhead and contract structures, self-pay patients should always inquire about "prompt-pay" discounts or self-pay classification before scheduling to potentially lower this amount. It is worth noting that if a patient has a high-deductible plan that hasn't yet been met, they may end up paying more than the cash price if the insurance negotiated rate exceeds $1,700, making upfront payment the more economical choice in those specific scenarios.
The charged amount listed as $4,250 represents the facility's gross rate, which is significantly higher than the cash price and serves as the baseline before any discounts or insurance negotiations apply. This facility is located in Garden City, Kansas, and operates as a voluntary non-profit acute care hospital. The data provided does not include specific county or state average comparisons for this procedure, so patients should rely on the transparent cash median of $1,700 and the Medicare benchmark of $106.81 to understand the true cost range, rather than the inflated gross charges.