CT scan, neck (cervical spine)
Facility: Ellsworth County Medical Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $851
- Cash Discount Price: $945
- vs. Medicare Baseline: 7.97x 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 797% of the Medicare baseline (a markup of 697%). 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 | $430 - $453 | 403% |
| Triwest -All Plans | $444 | 416% |
| Humana | $444 - $898 | 416% |
| Va Ccn-All Plans | $444 | 416% |
| Healthy Blue Mcr Adv | $444 | 416% |
| UnitedHealthcare | $614 - $945 | 575% |
| Aetna | $850 | 796% |
| First Health - All Plans | $850 | 796% |
| Cigna | $898 | 841% |
| Healthy Blue Mcaid- All Other Plans | $945 | 885% |
| Medicaid / KanCare | $945 | 885% |
| Coventry Mcaid-All Plans | $945 | 885% |
| Providers Care-Wppa-All Plans | $1,418 | 1328% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Ellsworth County Medical Center, the cash price is $945, which matches the facility's gross charge and the highest negotiated rates from several payers. While the median amount paid by insurance members is $732, this figure represents the average across all plans and does not guarantee your specific out-of-pocket cost. It is important to note that for patients with high-deductible plans, paying the cash price of $945 upfront may actually be cheaper than the insurance negotiated rate, which can sometimes exceed the cash price depending on your specific plan. To maximize savings, you should ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if you pay in full within a short window, effectively bypassing the administrative costs associated with insurance claims.
This service is provided at a Critical Access Hospital in Ellsworth, Kansas, and the facility's pricing reflects the local market dynamics where commercial rates often differ significantly from federal benchmarks. The Medicare amount for this procedure is $106.81, serving as a baseline for evaluating the facility's markup; commercial negotiated rates typically range from 200% to 300% of this amount, though fair pricing is often defined closer to 120% to 150%. If you are concerned about balance billing or unexpected charges, remember that the No Surprises Act protects you from being billed for out-of-network services at in-network facilities, and you should always request a detailed, itemized bill before paying to ensure no errors or unbundled codes are included.