CT scan, neck (cervical spine)
Facility: Nmc Health
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $910
- Cash Discount Price: $1,107
- vs. Medicare Baseline: 8.52x 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 852% of the Medicare baseline (a markup of 752%). 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 |
|---|---|---|
| Bluestem Pace | $101 | 95% |
| Leading Age | $162 | 152% |
| Medicaid / KanCare | $162 | 152% |
| Aetna | $410 | 384% |
| Blue Cross Blue Shield | $480 | 449% |
| Wppa | $870 | 815% |
| Occunet | $949 | 888% |
| Samaritan Ministries International | $1,028 | 962% |
| Medincrease Health Plan | $1,028 | 962% |
| Prime Health Services | $1,186 | 1110% |
| UnitedHealthcare | $1,423 | 1332% |
| Cigna | $1,502 | 1406% |
Consumer Guidance & Cost Commentary
For a CT scan of the cervical spine at Nmc Health in Newton, Kansas, the facility's cash price of $1,107 is significantly lower than the negotiated rates charged to most insurance plans, which range from $1,010 to $1,502 depending on the carrier. While the facility's negotiated average of $910 is higher than its cash rate, patients with high-deductible plans may find paying the cash price upfront more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash price. It is important to note that commercial rates can sometimes be inflated by administrative costs and contract dynamics, making the cash option a strategic choice for those who do not require insurance coverage for this specific service.
To ensure you are not overcharged, you should request a full itemized bill before paying, as summary invoices often hide unbundled codes or services not rendered. If you receive a balance bill for the difference between the provider's full charge and your insurance payment, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Additionally, ask the billing department about prompt-pay discounts, which can reduce the cash price by up to 50% if paid in full within 30 days, bypassing the administrative overhead associated with insurance claims processing.