CT scan, neck (cervical spine)
Facility: Stafford County Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $766
- Cash Discount Price: $766
- vs. Medicare Baseline: 7.17x 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 717% of the Medicare baseline (a markup of 617%). 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 |
|---|---|---|
| Health Partners-All Plans | $728 | 682% |
| Va Ccn-All Plans | $766 | 717% |
| Humana | $766 | 717% |
| UnitedHealthcare | $766 | 717% |
| Medica Mcr- All Plans | $766 | 717% |
Consumer Guidance & Cost Commentary
For the CPT code 72125, representing a CT scan of the neck at Stafford County Hospital, the cash and negotiated rates are identical at $766.00, with no variation across the five major payers listed. This price is significantly higher than the state of Kansas average, which is 7.2 times the Medicare benchmark rate of $106.81. While commercial insurance contracts often result in higher prices due to administrative overhead and network tiering, the data shows that paying cash directly matches the negotiated amount. For patients with high-deductible plans, this parity suggests that paying out-of-pocket might be a viable option to avoid potential balance billing if the insurance allowed amount were to exceed the cash price, though in this specific case, the rates are already aligned.
Patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can reduce costs by 20% to 50% by bypassing insurance claims processing. Since the facility is a Critical Access Hospital owned by the local government, it is important to confirm that the $766.00 rate reflects the final charge rather than a summary bill, as itemized audits are necessary to identify any unbundled codes or services not rendered. If a patient receives a bill that appears higher than this rate, they should request a formal written audit to dispute errors, as over 80% of hospital bills contain mistakes that can be corrected through certified mail to the billing supervisor.