CT scan, neck (cervical spine)
Facility: Rooks County Health Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,370
- Cash Discount Price: $1,142
- vs. Medicare Baseline: 12.83x 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 1283% of the Medicare baseline (a markup of 1183%). 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 | $480 | 449% |
| Tricare | $716 | 670% |
| Celtic Mcr Adv | $716 | 670% |
| Veterans Admin - All Plans | $716 | 670% |
| Celtic Comm - All Other Plans | $787 | 737% |
| UnitedHealthcare | $1,370 | 1283% |
| Aetna | $1,370 | 1283% |
| Preferred Benefits Admin | $1,370 | 1283% |
| Preferred Hlthcare - All Other Plans | $1,447 | 1355% |
| Health Partners - All Plans | $1,447 | 1355% |
| Healthy Blue Mcaid - All Plans | $1,523 | 1426% |
Consumer Guidance & Cost Commentary
For the CT scan of the cervical spine at Rooks County Health Center in Plainville, Kansas, the facility's cash price of $1,142 is lower than the median negotiated rate of $1,370 paid by most major insurers, including UnitedHealthcare, Aetna, and Preferred Benefits Admin. While the facility is a Critical Access Hospital with government ownership, patients with high-deductible plans may find paying cash upfront more cost-effective than relying on insurance, as the negotiated rates often exceed the cash price. To maximize savings, consumers should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as billing systems may automatically submit claims to insurance even when a patient intends to pay out-of-pocket.
The facility's cash rate of $1,142 is also notably lower than the median negotiated rate of $1,370, which serves as a useful benchmark for understanding the administrative markup inherent in insurance billing. Although the data does not provide specific state or county average comparisons for this procedure, the significant difference between the cash price and the insurer-paid rates highlights how commercial contracts can inflate costs. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is crucial to verify the exact allowed amount with the hospital prior to treatment to avoid unexpected charges.