CT scan, neck (cervical spine)
Facility: Cloud County Health Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $2,567
- Cash Discount Price: $1,892
- vs. Medicare Baseline: 24.03x 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 2403% of the Medicare baseline (a markup of 2303%). 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 |
|---|---|---|
| Aetna | $2,432 - $2,513 | 2277% |
| Mpi-All Plans | $2,567 | 2403% |
| Pponext-All Plans | $2,567 | 2403% |
| Health Partners - All Plans | $2,567 | 2403% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Cloud County Health Center in Concordia, KS, the facility's cash and negotiated rates are identical at $2,567, which is notably higher than the state average. While the gross charge listed is $2,703, patients with high-deductible plans might find it financially advantageous to pay the cash rate of $1,892 directly, as this amount is significantly lower than the $2,567 insurance companies are willing to negotiate. To secure this lower price, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as billing systems often default to insurance processing once a card is on file. Signing a waiver to prevent automatic claims submission is essential to ensure the facility applies the cash discount rather than submitting the claim to an insurer.
This service is benchmarked against Medicare, which pays $106.81 for the same procedure, highlighting a substantial difference in reimbursement structures. Although the facility is a voluntary non-profit Critical Access Hospital, the negotiated rate of $2,567 exceeds the Medicare amount by 24%, reflecting the administrative costs and contract dynamics inherent in commercial insurance. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is crucial to verify that all ancillary services, such as specific lab tests or imaging, are covered under the same network agreement to avoid unexpected additional charges. Always request an itemized bill before paying to ensure no unbundled codes or services not rendered are included in the final invoice.