CT scan, neck (cervical spine)
Facility: Mercy Hospital Columbus
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,819
- Cash Discount Price: $1,629
- vs. Medicare Baseline: 17.03x 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 1703% of the Medicare baseline (a markup of 1603%). 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 |
|---|---|---|
| Centivo Contracted [320505] | $26 | 24% |
| Humana | $72 - $2,381 | 67% |
| Medicaid / KanCare | $72 - $1,819 | 67% |
| Blue Cross Blue Shield | $91 - $1,819 | 85% |
| UnitedHealthcare | $91 - $2,080 | 85% |
| Medicare (plans) | $100 - $1,892 | 94% |
| Health Systems Inc Contracted [320174] | $1,078 | 1009% |
| Insurance System Inc Contracted [320465] | $1,078 | 1009% |
| Administrative Payor Contracted [320005] | $1,128 | 1056% |
| Aetna | $1,819 - $2,255 | 1703% |
| Halo Hcr Inc Hospice [20432] | $1,819 | 1703% |
| Dept Of Veteran Affairs Contracted [320106] | $1,819 | 1703% |
| Elara Caring Aspire Hospice [20433] | $1,819 | 1703% |
| Centurion Of Missouri [20459] | $1,819 | 1703% |
| Home State Health Plan Contracted [320187] | $1,819 | 1703% |
| Kindful Hospice [20434] | $1,819 | 1703% |
| Mercy Hospice Okc [20252] | $1,819 | 1703% |
| Medical Associates Health Contracted [320444] | $1,819 | 1703% |
| Qual Choice Contracted [320325] | $1,819 | 1703% |
| Pace Of The Ozarks Contracted [320518] | $1,819 | 1703% |
| Provider Partners Health Plans Contracted [320450] | $1,819 | 1703% |
| Halo Hcr Inc Hospice Contracted [320432] | $1,819 | 1703% |
| Cherokee Nation Health Serv Contracted [320066] | $1,819 | 1703% |
| Ambetter / Centene | $1,819 | 1703% |
| Indian Health Service Contracted [320198] | $1,819 | 1703% |
| Cross Timbers Hospice [20098] | $1,819 | 1703% |
| Globalhealth Contracted [320145] | $1,819 | 1703% |
| Mercy Mgd Behavioral Health Contracted [320259] | $1,819 | 1703% |
| Kindful Hospice Contracted [320434] | $1,819 | 1703% |
| Cigna | $1,819 | 1703% |
| Novasys Contracted [320285] | $1,819 | 1703% |
| Tricare | $1,825 | 1709% |
| Healthscope Contracted [320182] | $1,932 | 1809% |
| Workers Comp [20426] | $2,005 - $2,130 | 1877% |
| United Medical Resources Contracted [320454] | $2,080 - $2,381 | 1947% |
| Medica Contracted [320239] | $2,245 | 2102% |
| American Healthcare Alliance Contracted [320020] | $2,255 | 2111% |
| First Health Contracted [320128] | $2,255 | 2111% |
| Preferred Health Plan Contracted [320522] | $2,255 | 2111% |
| Usa Managed Care Org Contracted [320429] | $2,255 | 2111% |
| Healthlink Contracted [320179] | $2,255 - $2,381 | 2111% |
| Federal Medical Center Contracted [320127] | $2,255 | 2111% |
| Mercy Benefit Admin Contracted [320251] | $2,255 - $2,381 | 2111% |
| Reflect Health Contracted [320492] | $2,381 | 2229% |
| Benefit Management Contracted [320052] | $2,381 | 2229% |
| Private Health Care Systems Contracted [320320] | $2,381 | 2229% |
| Edison Health Solutions Contracted [320502] | $2,381 | 2229% |
| Point C Contracted [320238] | $2,381 | 2229% |
| Imagine 360 Contracted [320494] | $2,381 | 2229% |
| 90 Degree Benefits Contracted [320436] | $2,381 | 2229% |
| Aither Health Contracted [320449] | $2,381 | 2229% |
| Ppo Plus Contracted [320310] | $2,381 | 2229% |
| Show-Me Health Administrators Contracted [320483] | $2,381 | 2229% |
| Yuzu Health Contracted [320521] | $2,381 | 2229% |
| Auxiant Contracted [320462] | $2,381 | 2229% |
| Ebms Contracted [320493] | $2,381 | 2229% |
Consumer Guidance & Cost Commentary
For patients with high-deductible plans, paying cash upfront for this CT scan of the neck can be significantly more affordable than using insurance. While the facility's cash price is $1,629, the negotiated rates paid by major insurers like Humana and Medicaid/KanCare range from $72 to over $2,300, with a median negotiated amount of $1,819. This means that for many commercial payers, the cash price is lower than the amount the insurance company would allow. To secure this lower rate, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as billing systems often default to submitting claims to insurance even when a patient intends to pay out-of-pocket.
The facility's pricing is also notably higher than the Medicare benchmark, which serves as the objective baseline for healthcare costs. The Medicare allowed amount for this procedure is $106.81, while the facility's cash price is $1629, representing a markup of 1700% over the federal rate. Although the facility is a voluntary non-profit church-owned Critical Access Hospital in Columbus, KS, the wide variance in payer rates—from as low as $26 for some Centivo plans to over $2,300 for others—highlights the importance of verifying your specific plan's negotiated rate. Patients should avoid accepting summary bills and instead request a detailed, itemized statement to ensure no errors exist before finalizing payment.