CT scan, neck (cervical spine)
Facility: Providence Medical Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $133
- Cash Discount Price: $98
- vs. Medicare Baseline: 1.25x 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 |
|---|---|---|
| Medicaid / KanCare | $60 | 56% |
| UnitedHealthcare | $98 - $202 | 92% |
| Medicare (plans) | $98 | 92% |
| Tricare | $98 | 92% |
| Aetna | $98 - $321 | 92% |
| Cigna | $98 | 92% |
| Midland Care Connection | $98 | 92% |
| Kansas Superior Select | $103 | 96% |
| Celtic | $103 - $158 | 96% |
| Healthy Blue | $103 - $109 | 96% |
| Corizon | $128 | 120% |
| Well Path Prison | $138 | 129% |
| Employer Direct Healthcare | $138 | 129% |
| Centurion | $148 | 139% |
| Naphcare | $153 | 143% |
| Blue Cross Blue Shield | $158 - $255 | 148% |
| Comp Alliance - Fka Compresults Worker Compensation | $193 | 181% |
| Oha Networks | $208 | 195% |
| Worker Compensation | $214 | 200% |
| First Health | $750 | 702% |
Consumer Guidance & Cost Commentary
For this CT scan of the cervical spine at Providence Medical Center in Kansas City, KS, the facility's cash price of $98.00 is significantly lower than the state average for this procedure, which sits at $337.80. While the facility's negotiated rates with commercial payers range from $60 to $750, the cash price remains the most affordable option available in this dataset. Patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price directly, as it avoids the administrative overhead and markup inherent in insurance billing cycles. To secure this lower rate, patients should explicitly request a "self-pay" classification and inquire about "prompt-pay" discounts, which can offer an additional reduction for upfront payment.
The facility's pricing structure is benchmarked against Medicare, which sets a fixed rate of $106.81 for this service. The facility's cash price of $98.00 is slightly below the Medicare benchmark, whereas the median negotiated rate paid by insurers is $133.00, representing a markup relative to the federal baseline. It is important to note that while the facility is a voluntary non-profit church-owned acute care hospital, the negotiated rates for in-network members can vary widely, with some plans paying as high as $750. Consumers should verify their specific plan's allowed amount before scheduling to ensure they are not paying a rate that exceeds the cash price or the Medicare benchmark.