CT scan, neck (cervical spine)
Facility: Clara Barton Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,232
- Cash Discount Price: $958
- vs. Medicare Baseline: 11.53x 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 1153% of the Medicare baseline (a markup of 1053%). 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 | $453 | 424% |
| 6 Degrees Health - All Plans | $958 | 897% |
| Wppa-All Plans | $1,095 | 1025% |
| UnitedHealthcare | $1,232 | 1153% |
| Phcs - All Plans | $1,232 | 1153% |
| Aetna | $1,232 | 1153% |
| Hlth Partners Of Ks-All Plans | $1,259 | 1179% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Clara Barton Hospital in Hoisington, KS, the cash price is $958, which is lower than the median negotiated rate of $1,232 paid by most insurance plans. While the facility's negotiated rate aligns with the state average for this procedure, the cash price offers a significant alternative for patients with high-deductible plans or those without insurance. Because commercial insurance rates often include administrative overhead and claim processing costs, paying cash upfront can result in immediate savings of up to $274 compared to the standard in-network allowed amount. Patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing the insurance billing cycle entirely.
The facility's rate is also 11.5% higher than the Medicare benchmark for this service, which serves as a reliable baseline for evaluating fair pricing. Although the hospital is a Critical Access Hospital with a voluntary non-profit ownership structure, the gap between the Medicare rate of $106.81 and the cash price of $958 highlights the substantial markup inherent in commercial billing. To ensure you are not overcharged, it is advisable to obtain a detailed, itemized bill that lists specific CPT codes rather than accepting a summary invoice. If you receive a balance bill for out-of-network ancillary services, you may have rights under the No Surprises Act to dispute the charges, but for this in-network procedure, comparing the cash price against the negotiated rate is the most effective way to manage your costs.