CT scan, neck (cervical spine)
Facility: Wilson Medical Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $701
- Cash Discount Price: $657
- vs. Medicare Baseline: 6.56x 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 656% of the Medicare baseline (a markup of 556%). 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 - $876 | 424% |
| Aetna | $464 - $876 | 434% |
| Ambetter / Centene | $464 - $876 | 434% |
| UnitedHealthcare | $464 - $815 | 434% |
| Humana | $464 | 434% |
| Tricare | $464 | 434% |
| Cigna | $701 | 656% |
| Health Partners-All Plans | $806 | 755% |
| Mulitplan-All Plans | $806 | 755% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Wilson Medical Center in Neodesha, KS, the billed amount varies significantly depending on your insurance plan. While the facility's gross charge is $876, the negotiated rates for in-network payers range from $453 to $806, with the median negotiated rate being $701. This facility is a Critical Access Hospital with government local ownership, and its pricing is benchmarked against the federal Medicare rate of $106.81. The data indicates a 6.6% variance relative to Medicare, which serves as the objective baseline for evaluating hospital pricing markups. It is important to note that while commercial negotiated rates often exceed the cash price due to administrative overhead and contract dynamics, patients with high-deductible plans may find the cash price of $657 more affordable if their insurance allowed amount exceeds this figure.
To minimize out-of-pocket costs, patients should verify their specific plan's allowed amount before scheduling, as in-network rates can vary widely among carriers. For this service, the cash median is $657, and the median paid under insurance is $511, suggesting that for some plans, the negotiated rate will be lower than the cash price. However, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid upfront, bypassing the costly insurance claims cycle. Since over 80% of hospital bills contain errors, consumers are advised to request a detailed, itemized statement rather than accepting a summary bill, and to dispute any balance billing immediately if it occurs, as federal protections like the No Surprises