CT scan, neck (cervical spine)
Facility: Saint Luke'S South Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,009
- Cash Discount Price: $3,593
- vs. Medicare Baseline: 9.45x 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 945% of the Medicare baseline (a markup of 845%). 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 |
|---|---|---|
| Medicaid / KanCare | $60 - $136 | 56% |
| Humana | $90 - $148 | 84% |
| UnitedHealthcare | $114 - $1,009 | 107% |
| Aetna | $115 - $5,689 | 108% |
| Cigna | $118 - $4,545 | 110% |
| Transplants-Case Rates [5750] | $159 - $5,988 | 149% |
| Blue Cross Blue Shield | $242 - $4,497 | 227% |
| Commercial-Contracted [8000] | $959 - $4,844 | 898% |
| First Health [5512] | $3,550 | 3324% |
Consumer Guidance & Cost Commentary
For a CT scan of the cervical spine at Saint Luke's South Hospital in Overland Park, Kansas, the facility's cash median price is $3,593, while the negotiated rate for Medicaid/KanCare plans is $60. This significant difference highlights that cash-paying patients with high-deductible plans may save money by paying directly, as the insurance negotiated rate often exceeds the cash price. However, patients should verify if their specific plan has a lower allowed amount before scheduling, as some commercial contracts can result in higher out-of-pocket costs than self-pay. Additionally, the facility offers a prompt-pay discount for upfront payment, which can further reduce the final bill by bypassing administrative fees and claims processing delays.
It is important to note that while the facility's cash rate is $3,593, the Medicare benchmark for this procedure is only $106.81, indicating a substantial markup common in commercial pricing. Patients should avoid comparing discounts to the hospital's gross charge of $5,988, as this inflates the perceived savings; instead, they should focus on the Medicare rate to understand the true cost basis. If a patient receives a surprise bill for out-of-network services, they have the right to dispute it under the No Surprises Act, and they should always request a detailed, itemized bill to identify any unbundled codes or services not rendered before agreeing to payment terms.