CT scan, neck (cervical spine)
Facility: Hamilton County Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,350
- Cash Discount Price: $1,500
- vs. Medicare Baseline: 12.64x 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 1264% of the Medicare baseline (a markup of 1164%). 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 | $215 - $480 | 201% |
| First Health Coventry - All Plans | $1,275 | 1194% |
| UnitedHealthcare | $1,425 | 1334% |
| Cigna | $1,425 | 1334% |
| Va Ccn - All Plans | $1,500 | 1404% |
| Aetna | $2,550 | 2387% |
Consumer Guidance & Cost Commentary
For this CT scan of the cervical spine at Hamilton County Hospital in Syracuse, KS, the cash price is $1,500, which matches the facility's negotiated rate and the state average. While the median amount paid by insurance is $1,425, commercial payers like Aetna and UnitedHealthcare have negotiated rates of $2,550 and $1,425 respectively, which are higher than the cash price. Because commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures, patients with high-deductible plans may save money by paying the cash price of $1,500 directly, provided they have not met their deductible. It is important to note that the Medicare benchmark for this service is $106.81, and the facility's cash rate represents a significant markup compared to this federal baseline, illustrating why comparing rates to the chargemaster can be misleading.
Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly insurance claims processing. Since the facility is a Critical Access Hospital with government local ownership, verifying the exact payment terms and requesting an itemized bill is essential to avoid balance billing or unexpected charges. If you receive a bill, always request a detailed line-by-line statement to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.