CT scan, neck (cervical spine)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $657
- Cash Discount Price: $659
- vs. Medicare Baseline: 6.15x 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 615% of the Medicare baseline (a markup of 515%). 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 | $380 | 356% |
| Tricare | $410 | 384% |
| UnitedHealthcare | $480 - $775 | 449% |
| Va Ccn - All Plans | $480 | 449% |
| Aetna | $480 - $698 | 449% |
| Medicaid / KanCare | $480 - $775 | 449% |
| Ambetter / Centene | $529 | 495% |
| Blue Cross Blue Shield | $657 | 615% |
| Health Partners - All Plans | $736 | 689% |
| Healthy Blue Mcaid - All Plans | $775 | 726% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck (cervical spine) at Trego County Lemke Memorial Hospital in Wakeeney, KS, the cash median price is $659.00, which is notably higher than the state average of $481.00. While commercial insurance plans like UnitedHealthcare and Medicaid/KanCare may negotiate rates as high as $775.00, the cash price remains the lowest available option for self-pay patients. This pricing structure highlights the importance of checking for "self-pay" or "prompt-pay" discounts before scheduling, as paying upfront can sometimes bypass the administrative overhead that inflates commercial negotiated rates.
It is important to note that Medicare rates for this procedure are set at $106.81, serving as a baseline for fair pricing; commercial rates often exceed this significantly due to contract dynamics. If you have a high-deductible plan, the cash price of $659.00 might be more affordable than your insurance's allowed amount, which could reach up to $775.00 depending on your specific carrier. To avoid unexpected balance billing or errors, always request a full itemized bill before paying, ensuring you are not being charged for services not rendered or unbundled components.