CT scan, neck (cervical spine)
Facility: Clay County Medical Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $95
- Cash Discount Price: $1,072
- vs. Medicare Baseline: 0.89x 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.
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 |
|---|---|---|
| Multiplan- All Plans | $47 - $1,942 | 44% |
| UnitedHealthcare | $69 - $1,942 | 65% |
| Health Partners - All Plans | $75 - $1,942 | 70% |
| Wppa/Providrs Care- All Plans | $93 - $1,901 | 87% |
| Aetna | $93 - $1,901 | 87% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Clay County Medical Center in Clay Center, Kansas, the cash price is $1,072, which matches the facility's median paid amount. This cash rate is significantly lower than the negotiated rates charged to insurance plans, where amounts range from $69 to $1,942 depending on the carrier. While the facility is a Critical Access Hospital with a government-local ownership structure, patients with high-deductible plans may find paying the full cash price upfront more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. To secure the lowest possible price, it is advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the bill if settled in full before or shortly after the service.
When reviewing your bill, be aware that commercial insurance rates are often inflated by administrative costs and contract dynamics, sometimes reaching 200% to 300% of the Medicare benchmark, whereas fair pricing is typically closer to 120% to 150% of that rate. In this case, the Medicare amount for this procedure is $106.81, providing a clear baseline to evaluate the facility's pricing markup. If you receive a bill that appears unexpectedly high, you should request a detailed, itemized audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes. Additionally, under the No Surprises Act, you are protected from balance billing for out-of-network services at in-network facilities, so you should dispute any surprise charges immediately rather than paying them out of fear of credit damage.