CT scan, neck (cervical spine)
Facility: University Of Ks Hlth System Great Bend Campus
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $531
- Cash Discount Price: $359
- vs. Medicare Baseline: 4.97x 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 497% of the Medicare baseline (a markup of 397%). 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 |
|---|---|---|
| Ku Athletics [503200094] | $98 | 92% |
| UnitedHealthcare | $98 | 92% |
| Workers Comp [503999901] | $98 | 92% |
| Medicare (plans) | $100 | 94% |
| Allwell [503200078] | $101 | 95% |
| Blue Cross Blue Shield | $101 | 95% |
| Triwest [503201703] | $103 | 96% |
| Humana | $103 | 96% |
| Tricare | $103 | 96% |
| Centurion [5032000966] | $127 | 119% |
| Ambetter / Centene | $142 | 133% |
| Fort Hays State Student Athletes [5032000960] | $205 | 192% |
| Occunet [503999930] | $205 | 192% |
| 6 Degrees Health [503999050] | $244 | 228% |
| Advanced Medical Pricing Solutions [503301513] | $309 | 289% |
| Alt Wppa [5032000964] | $753 | 705% |
| Meritain Health [503200039] | $753 - $1,076 | 705% |
| Wppa [503200056] | $753 | 705% |
| Alt Carelon Behavioral Health [503200905] | $897 | 840% |
| First Health [5032000110] | $1,076 | 1007% |
| Cigna | $1,076 - $1,435 | 1007% |
| Aetna | $1,076 | 1007% |
| Php [503200005] | $1,076 | 1007% |
| Allied National [503999937] | $1,076 | 1007% |
| Alt Meritain Health [503999911] | $1,076 | 1007% |
| Aha-Healthcare Preferred [503200050] | $1,076 | 1007% |
| National Assn Letter Carriers [503200019] | $1,076 | 1007% |
| Correct Care Solutions [50311253] | $1,256 | 1176% |
| Usa Managed Care [503999030] | $1,615 | 1512% |
Consumer Guidance & Cost Commentary
For this CT scan of the cervical spine, the facility's cash price of $359.00 is significantly lower than the average negotiated rates paid by insurance companies, which range from $98 to $1,435 depending on the payer. While the facility's negotiated rate of $531.00 is higher than the cash option, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allowed amount exceeds the cash price. It is important to note that the facility's cash rate is also lower than the state average for this procedure, making it a cost-effective option for those without insurance or with limited coverage.
The facility's performance against Medicare benchmarks indicates a markup of 5.0 times the Medicare rate of $106.81, which is consistent with commercial pricing structures where negotiated rates often average 200% to 300% of Medicare. To minimize costs, patients should request an itemized billing audit to review every line item for potential errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Additionally, asking about prompt-pay discounts before scheduling can provide immediate savings, as paying the cash price upfront often bypasses administrative fees and insurance processing delays.