CT scan, neck (cervical spine)
Facility: Ashland Health Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $667
- Cash Discount Price: $534
- vs. Medicare Baseline: 6.24x 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 624% of the Medicare baseline (a markup of 524%). 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 | $223 | 209% |
| Compalliance-All Plans | $534 | 500% |
| Health Partners Of Kansas-All Plans | $567 | 531% |
| Multiplan-All Plans | $654 | 612% |
| Healthy Blue Mcr Adv - All Other Plans | $667 | 624% |
| Medicaid / KanCare | $667 | 624% |
| UnitedHealthcare | $667 | 624% |
| Medica Mcare - All Plans | $667 | 624% |
| Aetna | $667 | 624% |
| Medicare (plans) | $667 | 624% |
| Health Choice-All Plans | $667 | 624% |
| Providers Care (Wppa)-All Plans | $1,000 | 936% |
Consumer Guidance & Cost Commentary
For the CPT code 72125, representing a CT scan of the neck at Ashland Health Center in Ashland, Kansas, the facility's cash median rate is $534.00, which is lower than the negotiated rates paid by most commercial payers listed. While the facility's negotiated rate of $667.00 matches the median paid across all payers, patients with high-deductible plans may find the cash price more advantageous if their insurance allows a rate exceeding $534.00. It is important to note that the facility's negotiated rate of $667.00 is significantly higher than the Medicare benchmark of $106.81, reflecting a common markup structure where commercial rates often exceed 200% of the Medicare base. To minimize costs, consumers should verify if the facility offers self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% when paid upfront, bypassing the administrative overhead associated with insurance claims processing.
When reviewing your bill, ensure you receive an itemized statement rather than a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If you receive a summary bill showing broad categories like "Laboratory" or "Pharmacy," request a full line-by-line breakdown before negotiating or paying to identify any discrepancies. Additionally, be aware that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is crucial to confirm your plan's deductible status before scheduling, as paying a high negotiated rate without meeting your deductible can result in significant out-of-pocket