CT scan, neck (cervical spine)
Facility: Mitchell County Hospital Health Systems
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,646
- Cash Discount Price: $1,560
- vs. Medicare Baseline: 15.41x 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 1541% of the Medicare baseline (a markup of 1441%). 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 | $107 - $1,733 | 100% |
| Blue Cross Blue Shield | $458 | 429% |
| Triwest Well Mark All Plans | $1,473 | 1379% |
| Aetna | $1,560 | 1461% |
| First Health-All Plans | $1,560 | 1461% |
| Pref Hlth Care Sytms Comm - All Plans | $1,560 | 1461% |
| Auxiant-All Plans | $1,646 | 1541% |
| Phc Leased Ntwrk Access - All Plans | $1,646 | 1541% |
| Multiplan Ppo - All Plans | $1,646 | 1541% |
| Health Partners Ks-All Plans | $1,716 | 1607% |
| Cigna | $1,716 | 1607% |
Consumer Guidance & Cost Commentary
For this CT scan of the cervical spine at Mitchell County Hospital Health Systems in Beloit, KS, the cash price is $1,560, which matches the median negotiated rate across 11 insurance plans. While the facility is a Critical Access Hospital with a government-local ownership structure, the cash price is notably higher than the Medicare benchmark of $106.81, reflecting a significant markup common in commercial billing. However, for patients with high-deductible plans, paying the cash price of $1,560 upfront may be more cost-effective than using insurance, as the negotiated rates for in-network payers like UnitedHealthcare and Blue Cross Blue Shield can result in higher out-of-pocket costs depending on individual plan deductibles and coinsurance.
To minimize potential surprise costs, patients should request a prompt-pay discount before scheduling, which could reduce the bill by 20% to 50% if paid in full within 30 days. It is also important to verify that all services are rendered and that the final invoice is fully itemized, as summary bills often hide unbundled charges or services not delivered. If a balance bill arises from an out-of-network ancillary service, patients should not pay immediately; instead, they should request a No Surprises Act audit to dispute the difference between the allowed amount and the full chargemaster rate.