CT scan, neck (cervical spine)
Facility: Morris County Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $823
- Cash Discount Price: $1,265
- vs. Medicare Baseline: 7.71x 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 771% of the Medicare baseline (a markup of 671%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $147 | 138% |
| Blue Cross Blue Shield | $456 - $823 | 427% |
| UnitedHealthcare | $823 - $2,109 | 771% |
| Coventry Mcr | $823 | 771% |
| Choice Care Mcr Adv-All Plans | $823 | 771% |
| Va Ccn-All Plans | $823 | 771% |
| Cigna | $1,526 | 1429% |
| Aetna | $1,890 | 1769% |
| Coventry Comm-All Other Plans | $1,898 | 1777% |
| Multiplan-All Plans | $1,898 | 1777% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Morris County Hospital in Council Grove, Kansas, the cash price is $1,265, which is lower than the facility's negotiated rates for most major insurers like UnitedHealthcare and Aetna. While the facility is a Critical Access Hospital with a government-local ownership structure, the cash rate of $1,265 is notably higher than the state average for this procedure. Patients with high-deductible plans or those without insurance may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates for many payers exceed the cash amount. It is important to verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final cost.
The Medicare benchmark for this service is $106.81, which serves as a baseline for evaluating the facility's pricing markup. The commercial negotiated rate of $823 is significantly higher than the Medicare amount, reflecting the administrative costs and contract dynamics inherent in insurance billing. Although the facility has a rating of 3, the pricing data indicates that the cash price is the most transparent and potentially lowest option compared to the varying negotiated ranges across different insurers. Consumers should be aware that balance billing is generally prohibited for emergency services at in-network facilities under federal law, but it is crucial to request an itemized bill to ensure no unexpected charges are applied.