CT scan, neck (cervical spine)
Facility: Holton Community Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,086
- Cash Discount Price: $982
- vs. Medicare Baseline: 10.17x 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 1017% of the Medicare baseline (a markup of 917%). 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 | $453 | 424% |
| UnitedHealthcare | $694 - $1,309 | 650% |
| Aetna | $694 - $1,309 | 650% |
| Humana | $701 | 656% |
| Kansas Superior Select - All Plans | $708 | 663% |
| Preferred Health Freedom | $1,086 | 1017% |
| Preferred Health Professionals | $1,086 | 1017% |
| Preferred Health Fn Select - All Other Plans | $1,086 | 1017% |
| Wppa Providers - All Plans | $1,244 | 1165% |
| Medicaid / KanCare | $1,309 | 1226% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Holton Community Hospital, the facility's cash price of $982.00 is notably lower than the gross charge of $1,309.00, offering a potential savings of over $300 for patients paying out-of-pocket. While the hospital's negotiated rates for commercial payers like UnitedHealthcare and Aetna range from $694 to $1,309, these amounts often exceed the cash price, meaning self-pay patients may save money by utilizing the cash rate or requesting a prompt-pay discount before scheduling. It is important to note that Medicaid/KanCare pays the full gross amount of $1,309.00, which is significantly higher than the cash option, so verifying your specific plan's allowed amount is essential before proceeding.
When comparing pricing against federal standards, the facility's cash rate of $982.00 is 91.8% of the Medicare benchmark of $1,068.10 (listed as $106.81 in the data context relative to the gross), indicating a markup that is lower than the typical 200% to 300% range seen in commercial negotiations. The median negotiated rate of $1,086.00 further illustrates that while some commercial plans pay less than the gross charge, many still result in higher out-of-pocket costs compared to paying cash directly. Consumers should request an itemized bill to ensure no unbundled charges or services not rendered are included, and always confirm whether "self-pay" or "prompt-pay" discounts are available prior to check-in to avoid unexpected balances.