CT scan, neck (cervical spine)
Facility: Wesley Medical Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $2,846
- Cash Discount Price: $16,449
- vs. Medicare Baseline: 26.65x 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 2665% of the Medicare baseline (a markup of 2565%). 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 |
|---|---|---|
| UnitedHealthcare | $60 | 56% |
| Medicaid / KanCare | $62 | 58% |
| Aetna | $62 - $5,872 | 58% |
| Amerigroup | $62 | 58% |
| First Health | $203 - $7,583 | 190% |
| Multiplan | $212 - $14,804 | 198% |
| United | $245 - $7,402 | 229% |
| Blue Cross Blue Shield | $480 | 449% |
| Health Partners Of Kansas | $2,846 - $8,224 | 2665% |
| Wppa | $2,862 | 2680% |
| Ambetter / Centene | $2,961 | 2772% |
| Medical Associates Health Plan | $3,109 | 2911% |
| Preferred Health Choices | $3,109 | 2911% |
| Spirit Aerosystems | $5,264 | 4928% |
| Triwest Healthcare Alliance | $10,692 | 10010% |
| Usa Managed Care | $13,982 | 13091% |
Consumer Guidance & Cost Commentary
This CT scan of the cervical spine at Wesley Medical Center in Wichita, KS, carries a cash median price of $16,449, which is significantly higher than the state average of $106.81. The facility's gross charge for this CPT code is also $16,449, reflecting the full list price before any discounts. While the cash rate is substantial, it is important to note that commercial insurance plans often negotiate rates that can exceed the cash price due to administrative overhead and contract structures; for instance, UnitedHealthcare and Aetna have high and low negotiated ranges of $60 and $62 respectively, while First Health and Multiplan have ranges extending up to $7,583 and $14,804. Patients with high-deductible plans should verify if paying the cash price directly would be more cost-effective than relying on insurance, as the negotiated rates for some payers are well above the cash rate.
To ensure you receive the most accurate pricing, it is recommended to request an itemized billing audit before finalizing payment, as summary bills often obscure specific code costs and potential errors. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the total bill by offering immediate liquidity incentives. Although the data shows a Medicare amount of $106.81 and a versus Medicare markup of 26.6%, commercial rates vary widely by insurer; for example, Medicaid/KanCare and Amerigroup have fixed negotiated rates of $62, whereas Health Partners of Kansas and WPPA have ranges of $2,846 to $8,224. Before