CT scan, neck (cervical spine)
Facility: Stormont Vail Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $98
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.92x 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 |
|---|---|---|
| Ambetter / Centene | $61 - $109 | 57% |
| UnitedHealthcare | $61 - $109 | 57% |
| Blue Cross Blue Shield | $62 - $613 | 58% |
| Humana | $96 - $98 | 90% |
| Aetna | $96 - $98 | 90% |
Consumer Guidance & Cost Commentary
For this CT scan of the cervical spine at Stormont Vail Hospital in Topeka, KS, the facility's negotiated rates range from $61 to $109 depending on your specific insurance plan, with a median paid amount of $109.00. It is important to note that while commercial negotiated rates often appear lower than the hospital's gross charge, they are frequently higher than the actual cost of care. In this case, the Medicare benchmark rate of $106.81 serves as the objective baseline for pricing; commercial rates typically average 200% to 300% of this amount, whereas fair pricing is generally defined as 120% to 150%. Because the facility's negotiated rates exceed the Medicare benchmark, patients with high-deductible plans might find that paying the cash price directly could result in lower out-of-pocket costs than using insurance, provided the cash price is available and verified.
Before scheduling, you should verify your specific plan's allowed amount and check for "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to confirm that all ancillary services, such as lab work or imaging, are also covered under your plan to avoid unexpected charges. If you receive a bill, always request a full itemized statement showing specific CPT codes rather than accepting a summary invoice, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.