CT scan, neck (cervical spine)
Facility: Kiowa County Memorial Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $712
- Cash Discount Price: $680
- vs. Medicare Baseline: 6.67x 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 667% of the Medicare baseline (a markup of 567%). 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 | $458 - $712 | 429% |
| UnitedHealthcare | $641 - $800 | 600% |
| Health Partners Of Ks-All Plans | $704 | 659% |
| Celtic Comml Exchange-All Other Plans | $712 | 667% |
| Aetna | $712 | 667% |
| Medica Prime Mcare Cost-All Plans | $712 | 667% |
| Humana | $712 | 667% |
| Medicaid / KanCare | $800 | 749% |
| Providrs Care/Wppa-All Plans | $1,200 | 1123% |
Consumer Guidance & Cost Commentary
For the CPT code 72125 (CT scan, neck), Kiowa County Memorial Hospital in Greensburg, KS, has a gross charge of $800.00. While the facility's cash median price is $680.00, which is lower than the gross charge, the negotiated rates for commercial payers range from $458 to $1,200. Notably, Medicaid/KanCare and the state's Medicaid program have a negotiated rate of $1,200, which is significantly higher than the cash price and exceeds the gross charge listed. This disparity highlights that for patients with high-deductible plans, paying the cash price of $680.00 upfront could result in substantial savings compared to the insurance negotiated rates, particularly for those with plans like Medicaid or specific commercial tiers that exceed the cash benchmark.
To minimize costs, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the final bill by 20% to 50%. It is also important to understand that the facility's negotiated rates are often inflated by administrative costs and contract dynamics, sometimes reaching 200% to 300% of the Medicare benchmark rate of $106.81. While the data provided does not include specific county or state average comparisons for this code, patients are advised to request an itemized bill to ensure no errors exist, as over 80% of hospital bills contain discrepancies. Finally, if a patient receives care from an out-of-network provider at this facility, they may be subject to balance billing, though the No Surprises Act protects against surprise