CT scan, neck (cervical spine)
Facility: Pratt Regional Medical Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $174
- Cash Discount Price: $723
- vs. Medicare Baseline: 1.63x 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 |
|---|---|---|
| Celtic Insurance Company | $102 | 95% |
| Healthy Blue | $105 | 98% |
| UnitedHealthcare | $112 - $1,928 | 105% |
| Christian Health Aid | $131 - $1,418 | 123% |
| Health Partners Of Kansas | $148 - $1,607 | 139% |
| Aetna | $157 - $1,701 | 147% |
| Choicecare | $174 - $1,890 | 163% |
Consumer Guidance & Cost Commentary
For a CT scan of the cervical spine at Pratt Regional Medical Center in Pratt, KS, the facility's cash median price is $723.00, which is lower than the negotiated rates paid by major insurers like UnitedHealthcare (up to $1,928) and Aetna (up to $1,701). This pricing structure highlights a common billing dynamic where commercial insurance contracts often result in higher net costs for patients compared to self-pay options, particularly for those with high-deductible plans. While the facility's negotiated rate of $174.00 appears lower than the cash price, this figure represents the maximum amount an insurer will pay under contract, not necessarily the final out-of-pocket cost for a patient who has not yet met their deductible. Patients should verify their specific plan's allowed amount and deductible status before scheduling, as paying the full cash price upfront may sometimes be more cost-effective than relying on insurance reimbursement if the insurer's allowed amount exceeds the cash rate.
To ensure you are not overcharged, it is advisable to request a detailed, itemized bill before finalizing payment, as summary bills can obscure individual charges or unbundled services. Additionally, ask the billing department about "prompt-pay" discounts, which can reduce the total cost by 20% to 50% if settled in full within a short window, bypassing the administrative overhead of insurance claims processing. If you receive a balance bill for the difference between the provider's chargemaster rate and your insurance allowed amount, you may be protected under the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services at in-network facilities. Always dispute any unexpected bills in writing and