CT scan, neck (cervical spine)
Facility: Scott County Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,036
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 9.70x 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 970% of the Medicare baseline (a markup of 870%). 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 |
|---|---|---|
| UnitedHealthcare | $60 - $1,380 | 56% |
| Blue Cross Blue Shield | $480 | 449% |
| Humana | $610 | 571% |
| Wppa | $872 - $1,200 | 816% |
| Aetna | $1,308 | 1225% |
Consumer Guidance & Cost Commentary
For the CPT code 72125 (CT scan, neck), Scott County Hospital's negotiated rates range from $480 to $1,380 depending on your specific insurance plan, with UnitedHealthcare plans showing the widest variation between $60 and $1,380. The median negotiated amount across all payers is $1,036, which is significantly higher than the Medicare benchmark of $106.81, indicating a substantial markup typical of commercial contracts. While the facility is a Critical Access Hospital in Scott City, KS, and operates as a voluntary non-profit, the data does not provide a specific county or state average for this procedure to compare against. However, it is important to note that cash-pay rates are not listed for this service, meaning patients without insurance coverage may not be able to utilize potential cash discounts unless they explicitly request a self-pay classification before scheduling.
Patients should be aware that while insurance often covers the cost, the negotiated rate may still exceed the theoretical cash price if a cash-pay option were available, making upfront payment a viable strategy for those with high deductibles. To minimize costs, you should contact the hospital directly to inquire about "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full within a short window, bypassing the administrative overhead of insurance claims. Additionally, if you receive a bill after using insurance, ensure it is an itemized statement rather than a summary bill, as hospitals may include unbundled codes or services not rendered. If you encounter unexpected charges, you have the right to dispute them in writing and request a review under the No Surprises Act, particularly if any