CT scan, neck (cervical spine)
Facility: Phillips County Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $580
- Cash Discount Price: $515
- vs. Medicare Baseline: 5.43x 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 543% of the Medicare baseline (a markup of 443%). 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 |
|---|---|---|
| UnitedHealthcare | $464 - $632 | 434% |
| Blue Cross Blue Shield | $470 - $512 | 440% |
| Medicaid / KanCare | $580 - $632 | 543% |
| Health Partners-All Plans | $580 - $632 | 543% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Phillips County Hospital in Phillipsburg, KS, the facility's cash median price is $515.00, which is lower than the state average of $580.00. While many patients assume insurance offers the best deal, this procedure's negotiated rates range from $464 to $632 depending on the payer, meaning the cash price is often the most affordable option for those with high-deductible plans or no coverage. Because the facility is a Critical Access Hospital with government local ownership, it may offer additional self-pay or prompt-pay discounts if you pay upfront, so it is advisable to ask about these rates before scheduling to ensure you are not paying the full negotiated amount.
The Medicare benchmark for this service is $106.81, which serves as a baseline to evaluate the facility's pricing markup. The facility's cash rate of $515.00 is approximately 4.8 times the Medicare amount, reflecting the standard administrative and operational costs included in commercial billing. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, though the No Surprises Act protects you from such bills for emergency care and non-emergency services at in-network facilities. To avoid errors, always request a full itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered, and you should dispute any discrepancies in writing rather than accepting verbal assurances.