CT scan, neck (cervical spine)
Facility: Lane County Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $950
- Cash Discount Price: $950
- vs. Medicare Baseline: 8.89x 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 889% of the Medicare baseline (a markup of 789%). 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 |
|---|---|---|
| UnitedHealthcare | $855 - $950 | 800% |
| Aetna | $855 - $902 | 800% |
| Healthy Blue Mcr Adv - All Other Plans | $950 | 889% |
| Medicaid / KanCare | $950 - $1,045 | 889% |
| Healthy Blue Mcaid | $950 | 889% |
| Wppa Providers-All Plans | $1,425 | 1334% |
Consumer Guidance & Cost Commentary
For the CPT code 72125, representing a CT scan of the neck at Lane County Hospital in Dighton, KS, the cash price is $950.00, which matches the facility's median negotiated rate and the median amount paid by insurers. This cash price is significantly higher than the Medicare benchmark of $106.81, indicating a substantial markup relative to the federal cost baseline. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data shows that in-network payers like UnitedHealthcare and Aetna negotiate rates ranging from $855 to $950, which aligns closely with the cash price. Patients with high-deductible plans may find paying the full $950 cash upfront more cost-effective than relying on insurance, as the negotiated rates do not offer a meaningful discount over the cash price.
It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details before scheduling. If you have insurance, check your deductible status, as paying the full negotiated rate may not be covered until that threshold is met. For those without insurance or with limited coverage, the $950 cash price serves as a reliable benchmark for budgeting. To potentially lower this amount, patients should contact the hospital directly to inquire about self-pay or prompt-pay discounts, which often provide immediate fee reductions for upfront payment. Additionally, if you receive an itemized bill, review it carefully for errors such as unbundled codes or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected through a formal audit dispute