CT scan, neck (cervical spine)
Facility: Menorah Medical Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $486
- Cash Discount Price: $11,384
- vs. Medicare Baseline: 4.55x 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 455% of the Medicare baseline (a markup of 355%). 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 |
|---|---|---|
| United | $60 - $5,123 | 56% |
| Amerigroup | $60 | 56% |
| Healthyblue | $61 | 57% |
| Aetna | $62 - $5,806 | 58% |
| Unicare | $62 | 58% |
| Medicaid / KanCare | $62 | 58% |
| Home State Health Plan | $95 | 89% |
| Cigna | $122 - $9,107 | 114% |
| Multiplan | $171 - $8,424 | 160% |
| Corvel Corporation | $203 - $7,400 | 190% |
| Oha Network | $212 - $5,692 | 198% |
| Blue Cross Blue Shield | $325 - $5,123 | 304% |
| Humana | $365 - $471 | 342% |
| Ambetter / Centene | $2,117 | 1982% |
| Nhc Advantage | $2,163 | 2025% |
| Wppa Providrs Care Network | $2,277 | 2132% |
| Universal Healthcare | $3,984 | 3730% |
| Coventry | $4,576 | 4284% |
| Coventry Kc Mo | $4,668 | 4370% |
| College Park Family Care Center | $4,895 | 4583% |
| Cco, Inc. | $8,538 | 7994% |
| Focus Healthcare Mgmt, Inc | $8,538 | 7994% |
| Triwest Health Alliance | $8,538 | 7994% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Menorah Medical Center in Overland Park, Kansas, the cash price is $11,384.00, which matches the facility's reported median paid amount. This cash rate is significantly higher than the state average of $106.81, reflecting the typical markup found in commercial healthcare pricing. While commercial insurance plans like United and Aetna negotiate rates ranging from $60 to $9,107, these negotiated amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying cash directly can be more cost-effective, provided the patient secures a "self-pay" or "prompt-pay" discount before scheduling. Patients should verify these discounts with the hospital's billing department, as upfront payment can sometimes bypass administrative fees and reduce the final bill.
It is important to distinguish between the facility's gross charges and the actual rates paid by insurers. The gross charge listed is $11,384.00, but commercial payers like Cigna and Multiplan have negotiated rates that vary widely, with some plans paying as high as $8,424.00. To ensure you are not overpaying, request an itemized billing audit to confirm that no unbundled codes or services not rendered are included in your statement. Additionally, compare your facility's negotiated rates against the Medicare benchmark of $106.81; commercial rates are often 200% to 300% of this baseline, whereas fair pricing is typically defined as 120% to 150%. Always check your deductible status before using insurance, as paying out-of-pocket may