CT scan, neck (cervical spine)
Facility: Great Plains Of Sabetha
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $630
- Cash Discount Price: $663
- vs. Medicare Baseline: 5.90x 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 590% of the Medicare baseline (a markup of 490%). 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 |
|---|---|---|
| Celtic Mcr Adv | $345 | 323% |
| Aetna | $348 - $670 | 326% |
| Celtic Comm Exchange-All Other Plans | $431 | 404% |
| Great West Healthcare-All Plans | $564 | 528% |
| UnitedHealthcare | $617 - $663 | 578% |
| Century/Wppa/Providers-All Plans | $630 | 590% |
| Multiplan-Phcs-All Plans | $630 | 590% |
| Humana | $630 | 590% |
| Cigna | $630 | 590% |
| Federated Mutual Ins-All Plans | $636 | 595% |
| Blue Cross Blue Shield | $663 | 621% |
| Medicaid / KanCare | $663 | 621% |
Consumer Guidance & Cost Commentary
For the CT scan of the cervical spine at Great Plains Of Sabetha, the cash price is $663.00, which matches the facility's negotiated rate and the cash median. While the facility is a Critical Access Hospital in Kansas, the data does not provide specific county or state average rates for comparison. It is important to note that for patients with high-deductible plans, paying the cash price of $663.00 upfront can sometimes be more cost-effective than relying on insurance, as commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. Patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the costly claims processing cycle and provide immediate liquidity benefits.
The Medicare benchmark for this procedure is $106.81, which serves as a scientifically validated baseline for evaluating pricing markups. The facility's cash price of $663.00 represents a significant markup relative to this federal rate, a common dynamic where commercial rates average 200% to 300% of Medicare amounts. If you are billed by an out-of-network provider at this facility, the No Surprises Act protects you from balance billing for emergency care and non-emergency services at in-network locations. Should you receive a surprise bill, you should dispute it in writing with the insurer and request a formal audit rather than accepting the charge immediately or signing away your rights via consent waivers.