CT scan, neck (cervical spine)
Facility: Nemaha Valley Community Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $869
- Cash Discount Price: $1,558
- vs. Medicare Baseline: 8.14x 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 814% of the Medicare baseline (a markup of 714%). 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% |
| Va Ccn - All Plans | $762 | 713% |
| Humana | $762 | 713% |
| Aetna | $769 - $1,471 | 720% |
| Celtic Comm Exch - All Plans | $838 | 785% |
| Partners Direct Health - All Plans | $900 | 843% |
| Multiplan - All Plans | $1,558 | 1459% |
| Health Partners - All Plans | $1,644 | 1539% |
| Midlands Choice - All Plans | $1,644 | 1539% |
Consumer Guidance & Cost Commentary
For the CT scan of the cervical spine at Nemaha Valley Community Hospital in Seneca, Kansas, the facility's cash price of $1,558 is significantly higher than the state average, which is $900. While commercial insurance plans like Aetna and Celtic Comm Exch have negotiated rates ranging from $762 to $1,644, these amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurance negotiated ceiling can sometimes be higher than the self-pay amount. It is important to verify the specific allowed amount for your plan before scheduling, as in-network rates vary widely across different carriers.
To minimize costs, we recommend requesting a prompt-pay discount from the hospital before your visit, which can reduce the bill by 20% to 50% for upfront payment. Additionally, since the facility is a Critical Access Hospital, you should ask for an itemized billing audit to ensure no errors or unbundled charges are included in the final statement. The Medicare benchmark for this service is $106.81, indicating that the commercial rates charged here are substantially higher than the federal baseline. Always confirm whether your specific plan has met its deductible before relying on insurance coverage, as paying out-of-pocket may result in a lower total cost than the negotiated rate your insurer would apply.