CT scan, neck (cervical spine)
Facility: Girard Medical Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $805
- Cash Discount Price: $1,380
- vs. Medicare Baseline: 7.54x 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 754% of the Medicare baseline (a markup of 654%). 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 | $480 - $805 | 449% |
| Kansas Superior Select-All Plans | $805 | 754% |
| UnitedHealthcare | $805 - $2,185 | 754% |
| Medicare (plans) | $805 | 754% |
| Aetna | $805 - $4,025 | 754% |
| Humana | $805 | 754% |
| Ambetter / Centene | $805 | 754% |
| Multiplan-All Plans | $2,128 | 1992% |
| Uhhis-All Plans | $2,185 | 2046% |
Consumer Guidance & Cost Commentary
For this CT scan of the cervical spine at Girard Medical Center, the negotiated rates vary significantly depending on your insurance plan, ranging from a low of $480 to a high of $2,185. While the facility's median negotiated rate is $805, patients with high-deductible plans might find that paying the cash price of $1,380 is actually more expensive than the insurance allowed amount, though the cash median listed here is $1,380 which is higher than the median paid of $805, suggesting that for many insured patients, the out-of-pocket cost after insurance processing is lower than the cash price. It is important to note that cash-pay options can sometimes be cheaper for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price, so verifying your specific deductible status before scheduling is crucial. Additionally, patients should always ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can offer a fee reduction of 20% to 50% for upfront payment, effectively bypassing the administrative costs associated with insurance claims processing.
The facility's pricing is benchmarked against the Medicare rate of $106.81 for this procedure, which serves as a scientifically validated baseline for the true cost of care. Commercial negotiated rates often average 200% to 300% of Medicare, while fair pricing is typically defined as 120% to 150% of Medicare, meaning the $805 median paid rate represents a significant markup over the federal government's fixed reimbursement. Since over 80% of hospital bills contain errors, patients should request a detailed, item