CT scan, neck (cervical spine)
Facility: Stevens County Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $670
- Cash Discount Price: $770
- vs. Medicare Baseline: 6.27x 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 627% of the Medicare baseline (a markup of 527%). 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 |
|---|---|---|
| Humana | $285 | 267% |
| Aetna | $293 - $770 | 274% |
| Blue Cross Blue Shield | $456 - $480 | 427% |
| First Health - All Plans | $693 | 649% |
| Wppa - All Plans | $732 | 685% |
| Medicaid / KanCare | $770 | 721% |
Consumer Guidance & Cost Commentary
For this CT scan of the cervical spine at Stevens County Hospital in Hugoton, Kansas, the cash price is $770.00, which matches the facility's gross chargemaster rate. While commercial insurance plans like Aetna and Blue Cross Blue Shield have negotiated rates ranging from $293 to $770, the cash price remains the highest fixed amount listed. It is important to note that paying cash upfront can sometimes be more cost-effective than relying on insurance, particularly if your plan has a high deductible or if the negotiated rate exceeds the cash price. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can reduce the final bill by 20% to 50% when paid in full within a short window.
When evaluating the cost against national standards, the Medicare benchmark for this procedure is $106.81, indicating that the facility's cash rate is significantly higher than the federal baseline. Although the data does not provide specific county or state average figures for this exact code, the facility is a Critical Access Hospital with a government-local ownership structure, which often influences pricing dynamics. To ensure you are not overcharged, you should request an itemized bill to verify that all services rendered are accurately coded and that no unbundled charges or services not delivered are included. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act generally protects you from paying the difference between the provider's rate and your insurance allowed amount for emergency care or non-emergency services at in-network facilities.