CT scan, neck (cervical spine)
Facility: Lincoln County Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $480
- Cash Discount Price: $1,193
- vs. Medicare Baseline: 4.49x 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 449% of the Medicare baseline (a markup of 349%). 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 | $480 | 449% |
Consumer Guidance & Cost Commentary
For a CT scan of the cervical spine at Lincoln County Hospital in Lincoln, KS, the facility's cash price is $1,193.00, which is lower than the state average of $1,325.00. While Blue Cross Blue Shield negotiates a rate of $480.00 for this service, patients should be aware that cash payments can sometimes be more cost-effective than using insurance if their deductible is high or if the negotiated rate exceeds the cash price. Because this facility is a Critical Access Hospital owned by the local government, it may offer specific self-pay or prompt-pay discounts that are not reflected in the standard cash median; patients are encouraged to contact the billing department directly before scheduling to confirm these potential reductions.
It is important to distinguish between the facility's gross charge of $1,325.00 and the actual amounts paid, as the latter represents the true cost to the patient. The Medicare benchmark for this procedure is $106.81, which serves as the objective baseline for evaluating pricing fairness, revealing that commercial rates often include significant markups. If you receive a bill from an out-of-network provider or encounter unexpected charges, you have the right to dispute balance billing under the No Surprises Act, particularly for emergency care or non-emergency services at in-network facilities. Furthermore, since over 80% of hospital bills contain errors, you should request a detailed, itemized statement to verify that all codes are accurate and that no services were unbundled or double-billed before agreeing to any payment plan.