CT scan, neck (cervical spine)
Facility: Graham County Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $492
- Cash Discount Price: $635
- vs. Medicare Baseline: 4.61x 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 461% of the Medicare baseline (a markup of 361%). 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 |
|---|---|---|
| UnitedHealthcare | $171 - $603 | 160% |
| Medicaid / KanCare | $171 | 160% |
| Blue Cross Blue Shield | $453 | 424% |
| Medicare (plans) | $476 | 446% |
| Celtic Commercial-All Other Plans | $524 | 491% |
| Wppa (Providers Care)-All Plans | $603 | 565% |
Consumer Guidance & Cost Commentary
For this CT scan of the cervical spine at Graham County Hospital in Hill City, Kansas, the cash price is $635, which matches the facility's median paid amount. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rates vary significantly by payer. Medicaid / KanCare and Blue Cross Blue Shield have fixed negotiated rates of $171 and $453 respectively, whereas Medicare allows a payment of $106.81. The commercial negotiated rate for UnitedHealthcare ranges from $171 to $603 across three plans, with the highest rate matching the gross charge. It is important to note that for patients with high-deductible plans, paying the cash price of $635 upfront may be more cost-effective than relying on insurance, as the negotiated rates for some commercial payers can exceed the cash amount. Additionally, patients should verify if their specific plan falls within the $171 to $603 range for UnitedHealthcare before scheduling to avoid unexpected costs.
To ensure you are getting the best possible rate, it is recommended to request a self-pay or prompt-pay discount directly from the hospital before your visit, as these discounts can reduce the bill by 20% to 50%. If you choose to use insurance, be aware that the facility may submit a claim to your insurer automatically, which could void any cash discount agreement you signed; therefore, signing a waiver of insurance submission at registration is crucial if you intend to pay out-of-pocket. Furthermore, while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services at in-network facilities, you should still review your itemized bill to ensure no unb