CT scan, neck (cervical spine)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,328
- Cash Discount Price: $2,573
- vs. Medicare Baseline: 12.43x 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 1243% of the Medicare baseline (a markup of 1143%). 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% |
| Aetna | $1,184 - $1,930 | 1109% |
| UnitedHealthcare | $1,472 | 1378% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Community Memorial Healthcare in Marysville, Kansas, the cash price is $2,573, which matches the facility's median paid amount. While the facility is a Critical Access Hospital with a voluntary non-profit status, the negotiated rates vary significantly by insurer; for example, Aetna plans pay between $1,184 and $1,930, whereas UnitedHealthcare pays a flat $1,472. It is important to note that the cash price is actually higher than the median negotiated rates for most major payers, meaning patients with high-deductible plans might save money by paying out-of-pocket or by utilizing a prompt-pay discount if available, rather than relying on insurance to cover the full cost.
When evaluating the cost of this procedure, it is crucial to compare rates against the Medicare benchmark rather than the hospital's gross charge. The Medicare amount for this service is $106.81, and the facility's cash rate is 12.4 times the Medicare amount, which falls within the typical range of fair pricing (120% to 150% of Medicare). Patients should be aware that balance billing is largely prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, so unexpected bills for out-of-network ancillary services are less likely but still possible if not properly reviewed. To ensure you are not overcharged, always request an itemized bill before paying and verify that all services listed were actually rendered, as summary bills often hide errors or unbundled charges that can inflate your total.