CT scan, neck (cervical spine)
Facility: Ellinwood District Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $413
- Cash Discount Price: $502
- vs. Medicare Baseline: 3.87x 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 387% of the Medicare baseline (a markup of 287%). 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 | $413 | 387% |
| UnitedHealthcare | $413 | 387% |
| Aetna | $413 | 387% |
| Cigna | $413 | 387% |
| Humana | $413 | 387% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Ellinwood District Hospital, the negotiated rate for in-network insurance is $413, which matches the lowest and highest paid amounts across all five major payers including Blue Cross Blue Shield, UnitedHealthcare, Aetna, Cigna, and Humana. This negotiated rate is significantly higher than the cash price of $502.00, meaning patients with high-deductible plans or those paying out-of-pocket might find the cash rate more affordable if they qualify for self-pay discounts. While the facility is a Critical Access Hospital in Ellinwood, KS, the data does not provide specific county or state average comparisons for this procedure, so the $413 negotiated rate should be viewed as the standard expected cost for insured members at this location.
It is important to note that the $413 amount represents the maximum allowed by insurance contracts, not the hospital's full chargemaster list price, which is $590.00. Under federal protections like the No Surprises Act, patients should not be balance billed for out-of-network services at this in-network facility, though they should verify that ancillary services like labs or radiology are also covered under the same network agreement. If you are paying cash, you should explicitly ask the billing department for a "self-pay" or "prompt-pay" discount before scheduling, as paying upfront can sometimes reduce the final cost further than the listed cash median. Always request a full itemized bill before paying to ensure no unbundled codes or services not rendered are included in the final charge.