CT scan, neck (cervical spine)
Facility: Lmh
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $105
- Cash Discount Price: $905
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Cigna | $39 - $2,419 | 37% |
| UnitedHealthcare | $39 - $2,404 | 37% |
| Medicare (plans) | $39 - $105 | 37% |
| Humana | $39 - $105 | 37% |
| Blue Cross Blue Shield | $46 - $2,343 | 43% |
| Haskell Indian Health Services | $46 - $105 | 43% |
| Ambetter / Centene | $47 - $163 | 44% |
| Allwell | $47 - $107 | 44% |
| Aetna | $1,835 - $3,005 | 1718% |
| Non Contracted | $2,897 | 2712% |
| First Health | $3,367 | 3152% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Lmh in Lawrence, KS, the cash median price is $905.00, which is significantly lower than the facility's gross charge of $3,621.00. While Medicare rates for this procedure are set at $106.81, commercial insurance negotiated rates vary widely, ranging from $39 to $3,367 depending on the payer. For instance, Aetna plans pay up to $3,005, whereas Cigna and UnitedHealthcare plans pay between $39 and $2,419. Because cash prices often fall below commercial negotiated rates, patients with high-deductible plans may save money by paying out-of-pocket, provided they verify the facility's "self-pay" or "prompt-pay" discounts before scheduling.
To ensure you are receiving the best possible rate, it is important to understand that hospitals often issue summary bills that obscure individual line items, potentially hiding unbundled charges or services not rendered. If you receive a bill that does not detail specific CPT codes, request a full itemized audit to identify errors or double-billing. Additionally, while the facility is in-network for many payers, be aware that some services, such as specific lab tests or ancillary procedures, might be billed separately if they are out-of-network. Always confirm your deductible status and ask for a written waiver of insurance submission if you intend to pay cash directly to avoid automatic claims processing that could void any agreed-upon discounts.