CT scan, neck (cervical spine)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $797
- Cash Discount Price: $839
- vs. Medicare Baseline: 7.46x 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 746% of the Medicare baseline (a markup of 646%). 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 |
|---|---|---|
| Tricare | $672 | 629% |
| Humana | $763 | 714% |
| Aetna | $776 - $839 | 727% |
| UnitedHealthcare | $797 | 746% |
| Hpk-All Plans | $797 | 746% |
| Medicaid / KanCare | $839 | 786% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash price is $839.00, which matches the facility's gross chargemaster rate. While commercial insurance plans like Aetna and UnitedHealthcare negotiate rates ranging from $763 to $839, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket or utilizing a "prompt-pay" discount if available. It is important to verify self-pay or prompt-pay rates before scheduling, as waiting until after receiving an insurance bill can result in higher costs due to administrative fees and the lack of immediate cash incentives.
This service is benchmarked against the Medicare rate of $106.81, which serves as the federal baseline for healthcare costs. The facility's cash price represents a significant markup compared to the Medicare amount, a common characteristic of commercial pricing structures where negotiated rates can average 200% to 300% of the Medicare rate. Since the data provided does not include specific county or state average comparisons for this procedure, patients should rely on the Medicare benchmark to understand the baseline cost and request an itemized billing audit to ensure no errors, such as unbundled codes or services not rendered, are included in the final invoice.