CT scan, neck (cervical spine)
Facility: Minneola District Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $490
- Cash Discount Price: $338
- vs. Medicare Baseline: 4.59x 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 459% of the Medicare baseline (a markup of 359%). 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 Community Care Program-All Plans | $44 - $412 | 41% |
| Humana | $44 - $412 | 41% |
| UnitedHealthcare | $44 - $615 | 41% |
| Aetna | $107 - $615 | 100% |
| Providrs Care Network-All Plans | $107 - $523 | 100% |
| Medicaid / KanCare | $107 - $615 | 100% |
| Blue Cross Blue Shield | $458 | 429% |
| Corporate Plan Management-All Plans | $523 | 490% |
| Preferred Health Care (Coventry)-All Other Plans | $554 | 519% |
| Triwest-All Plans | $554 | 519% |
| Phc (Coventry) Leased Network | $584 | 547% |
| Health Partners Of Kansas-All Plans | $584 | 547% |
Consumer Guidance & Cost Commentary
For the CT scan of the cervical spine at Minneola District Hospital, the cash price of $338.00 is significantly lower than the median negotiated rate of $554.00 paid by insurance plans. While the facility is a Critical Access Hospital in Kansas, the data indicates that cash payment may be the most cost-effective option for patients with high-deductible plans, as the insurance negotiated rates often exceed the cash price. To maximize savings, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative overhead and administrative markup inherent in the insurance billing cycle.
The facility's pricing structure reveals a wide variance in allowed amounts across different payers, ranging from a low of $44 to a high of $615, with a median negotiated amount of $490.00. It is important to note that commercial rates are often marked up significantly compared to the Medicare benchmark of $106.81, which serves as the objective baseline for true cost. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but unexpected charges can still occur if ancillary services are out-of-network. If a large bill arrives, consumers should demand a full itemized audit to identify errors or unbundled codes before agreeing to any payment plan.