CT scan, neck (cervical spine)
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $412
- Cash Discount Price: $1,134
- vs. Medicare Baseline: 3.86x 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 386% of the Medicare baseline (a markup of 286%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $60 - $490 | 56% |
| Medicaid / KanCare | $60 - $215 | 56% |
| Humana | $72 - $104 | 67% |
| Aetna | $72 - $105 | 67% |
| Provider Partners Health Plans Contracted [320450] | $77 | 72% |
| UnitedHealthcare | $91 - $1,613 | 85% |
| Halo Hcr Inc Hospice [20432] | $102 | 95% |
| Mercy Mgd Behavioral Health Contracted [320259] | $102 | 95% |
| Medical Associates Health Contracted [320444] | $102 | 95% |
| Medicare (plans) | $102 | 95% |
| Kindful Hospice Contracted [320434] | $102 | 95% |
| Cherokee Nation Health Serv Contracted [320066] | $102 | 95% |
| Tricare | $102 | 95% |
| Mercy Hospice Okc [20252] | $102 | 95% |
| Elara Caring Aspire Hospice [20433] | $102 | 95% |
| Kindful Hospice [20434] | $102 | 95% |
| Pace Of The Ozarks Contracted [320518] | $102 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $102 | 95% |
| Globalhealth Contracted [320145] | $102 | 95% |
| Qual Choice Contracted [320325] | $102 | 95% |
| Cigna | $102 - $467 | 95% |
| Cross Timbers Hospice [20098] | $102 | 95% |
| Centivo Contracted [320505] | $104 | 97% |
| Dept Of Veteran Affairs Contracted [320106] | $104 | 97% |
| First Health Contracted [320128] | $105 | 98% |
| United Medical Resources Contracted [320454] | $114 - $412 | 107% |
| Providrs Care Network Contracted [320484] | $197 | 184% |
| Insurance System Inc Contracted [320465] | $412 | 386% |
| Healthscope Contracted [320182] | $412 - $1,308 | 386% |
| Health Systems Inc Contracted [320174] | $412 | 386% |
| Point C Contracted [320238] | $412 - $1,308 | 386% |
| Benefit Management Contracted [320052] | $412 | 386% |
| Medica Contracted [320239] | $734 | 687% |
| Show-Me Health Administrators Contracted [320483] | $1,089 | 1020% |
| Mercy Benefit Admin Contracted [320251] | $1,089 - $1,221 | 1020% |
| Edison Health Solutions Contracted [320502] | $1,221 | 1143% |
| American Healthcare Alliance Contracted [320020] | $1,221 | 1143% |
| Yuzu Health Contracted [320521] | $1,221 | 1143% |
| Aither Health Contracted [320449] | $1,221 | 1143% |
| Reflect Health Contracted [320492] | $1,221 | 1143% |
| Auxiant Contracted [320462] | $1,221 - $1,308 | 1143% |
| Ebms Contracted [320493] | $1,221 | 1143% |
| Imagine 360 Contracted [320494] | $1,221 | 1143% |
| Federal Medical Center Contracted [320127] | $1,308 | 1225% |
| Healthlink Contracted [320179] | $1,308 | 1225% |
| Preferred Health Plan Contracted [320522] | $1,308 | 1225% |
| Compcare Of The Ozarks Contracted [320437] | $1,378 | 1290% |
| Workers Comp [20426] | $1,395 | 1306% |
| Private Health Care Systems Contracted [320320] | $1,613 | 1510% |
| Multiplan Contracted [320270] | $1,657 | 1551% |
| Multiplan [20270] | $1,657 | 1551% |
Consumer Guidance & Cost Commentary
For this CT scan of the cervical spine, the facility's cash price of $1,134 is significantly lower than the negotiated rates charged to most insurance payers, which range from $60 to $1,657. While the facility's cash rate is higher than the national average for this procedure, it remains substantially below the highest negotiated amounts seen in the data, such as the $1,657 charged by Multiplan. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. To secure the lowest possible cost, patients should explicitly ask the billing department about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%.
The data also reveals significant variation in how different insurers pay for this service, with some plans paying as little as $60 while others pay up to $1,613. This disparity highlights the importance of verifying your specific plan's negotiated rate before receiving care, as assuming that being in-network guarantees the best price is a common pitfall. Additionally, patients should be aware of balance billing risks if they receive out-of-network ancillary services, even at an in-network facility, and should dispute any unexpected bills using the No Surprises Act protections. Finally, because over 80% of hospital bills contain errors, patients should request a detailed, itemized statement to audit for unbundled codes or services not rendered, ensuring the final charge reflects only what was actually provided.