CT scan, neck (cervical spine)
Facility: St Luke Hospital & Living Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $709
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 6.64x 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 664% of the Medicare baseline (a markup of 564%). 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 |
|---|---|---|
| Va Ccn | $709 | 664% |
| Blue Cross Blue Shield | $709 | 664% |
| Humana | $709 | 664% |
| Kansas Department Of Health And Environment | $709 | 664% |
| Bluestem Pace | $709 | 664% |
| UnitedHealthcare | $709 | 664% |
| Ambetter / Centene | $716 | 670% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate is $709, which aligns exactly with the lowest and highest negotiated amounts reported across all seven payers, including UnitedHealthcare and Blue Cross Blue Shield. This rate is significantly higher than the Medicare benchmark of $106.81, reflecting the standard commercial markup where negotiated rates often average 200% to 300% of the federal baseline. While the facility is a Critical Access Hospital owned by a Government Hospital District, the data does not provide specific cash or median paid figures to compare directly against state or county averages; however, patients should be aware that cash-pay options can sometimes result in lower out-of-pocket costs if their insurance negotiated rate exceeds the cash price, making it essential to inquire about self-pay or prompt-pay discounts before scheduling.
Because this service is covered under a specific CPT code with a single negotiated rate per payer, there is no variation in the allowed amount across different insurance plans, meaning the $709 charge applies uniformly to all in-network members. Under the No Surprises Act, patients are protected from balance billing for out-of-network providers at this in-network facility, though they should still verify that ancillary services like lab work are also covered under the same contract terms. To ensure accuracy, patients should request a full itemized billing audit rather than accepting a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or charges for services not rendered. Finally, if a patient has a high deductible, they may face the full $709 cost if their plan has not yet met its threshold, so confirming