CT scan, neck (cervical spine)
Facility: Hodgeman County Health Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,192
- Cash Discount Price: $1,354
- vs. Medicare Baseline: 11.16x 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 1116% of the Medicare baseline (a markup of 1016%). 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 | $435 - $458 | 407% |
| Medicaid / KanCare | $1,084 - $1,693 | 1015% |
| Triwest - All Plans | $1,084 | 1015% |
| UnitedHealthcare | $1,084 - $1,608 | 1015% |
| Humana | $1,084 | 1015% |
| Aetna | $1,354 | 1268% |
| First Health - All Plans | $1,524 | 1427% |
| Health Partners - All Plans | $1,608 | 1505% |
| Wppa (Provdrscare) - All Plans | $1,608 | 1505% |
Consumer Guidance & Cost Commentary
Hodgeman County Health Center, located at 809 Bramley in Jetmore, Kansas, performed a CT scan of the cervical spine with a cash median price of $1,354. This facility operates as a government-owned Critical Access Hospital, and while the cash rate is available, the median negotiated rate for insurance payers is $1,192, and the median paid rate is $1,273. For patients with high-deductible plans, the cash price of $1,354 may be more cost-effective than the negotiated rates of $1,084 to $1,693 charged by various insurers, including Blue Cross Blue Shield, Medicaid/KanCare, and UnitedHealthcare. Consumers are encouraged to verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling care, as these upfront payment incentives can significantly reduce out-of-pocket expenses.
The procedure's price transparency data indicates a Medicare benchmark of $106.81, with a markup ratio of 11.2 times the Medicare amount. Although specific comparative averages for the state or county were not provided in the dataset, the facility's pricing structure reflects the typical dynamics of Critical Access Hospitals where negotiated rates often exceed cash prices due to administrative overhead and contract dynamics. Patients should request an itemized billing audit to ensure no errors, unbundled codes, or services not rendered have inflated the final charge, and they should be aware that the No Surprises Act protects against balance billing for out-of-network services at in-network facilities. Always confirm your specific plan's allowed amount and deductible status prior to receiving treatment to avoid unexpected financial obligations.