CT scan, neck (cervical spine)
Facility: Kansas Medical Center Llc
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $96
- Cash Discount Price: $642
- vs. Medicare Baseline: 0.90x 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% |
| Indian Health | $87 | 81% |
| Tricare | $87 | 81% |
| Humana | $96 | 90% |
| Ambetter / Centene | $96 | 90% |
| Blue Cross Blue Shield | $96 - $437 | 90% |
| Medadv_Wellcare | $96 | 90% |
| Three_Rivers | $193 | 181% |
| Aetna | $450 | 421% |
| Wppa | $525 | 492% |
| United | $580 | 543% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Kansas Medical Center Llc in Andover, the cash median price is $642, which is lower than the facility's negotiated rates for most commercial payers. While the facility's cash rate is significantly lower than the gross charge of $1,070, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rate exceeds this amount. It is important to note that the facility's cash price is higher than the state average for this procedure, so patients should verify if their specific insurance plan has a lower allowed amount before scheduling. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, as these upfront fee reductions can further lower the final cost.
The Medicare benchmark for this service is $106.81, which serves as the objective baseline for evaluating pricing markups. Commercial negotiated rates for this procedure range from $60 to $580 across different payers, with the median negotiated rate being $96. Since Medicare rates represent the true cost of care delivery, comparing commercial rates to this benchmark reveals the extent of administrative markups and contract dynamics. Patients should avoid comparing discounts to the inflated gross charge list and instead focus on the Medicare rate to understand fair pricing. Furthermore, if a patient receives care from an out-of-network provider or encounters services not covered by their contract, they may face balance billing for the difference between the provider's full rate and the insurance allowed amount, though federal protections exist for emergency care at in-network facilities.