CT scan, neck (cervical spine)
Facility: Memorial Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,486
- Cash Discount Price: $2,703
- vs. Medicare Baseline: 13.91x 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 1391% of the Medicare baseline (a markup of 1291%). 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 | $484 | 453% |
| Tricare | $1,351 | 1265% |
| Humana | $1,351 | 1265% |
| Medicare (plans) | $1,365 | 1278% |
| Ambetter / Centene | $1,486 | 1391% |
| Coventry - All Other Plans | $2,432 | 2277% |
| Preferred Healthcare-All Plans | $2,567 | 2403% |
| Health Partners Of Kansas - All Plans | $2,567 | 2403% |
| Wppa/Providers Care-All Plans | $3,784 | 3543% |
Consumer Guidance & Cost Commentary
For CPT code 72125, a CT scan of the neck at Memorial Hospital in Abilene, KS, the cash price is $2,703.00, which matches the facility's median negotiated rate of $1,486.00. While the facility is a Critical Access Hospital with a government ownership structure, the cash price remains significantly higher than the Medicare benchmark of $106.81, indicating a substantial markup relative to the federal baseline. In this specific instance, the cash price is also notably higher than the lowest negotiated rates found across other payers in the region, such as Blue Cross Blue Shield at $484.00 and Tricare at $1,351.00. Patients should be aware that while cash payment may appear expensive compared to some commercial negotiated rates, it can still be more cost-effective than insurance billing if the patient's deductible has not yet been met, as they would be responsible for the full negotiated amount rather than the lower cash price.
To minimize out-of-pocket costs, patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% for upfront payment. It is crucial to request a waiver of insurance submission before scheduling the procedure to prevent the hospital from automatically submitting a claim that would void any cash discount agreement. Additionally, since over 80% of hospital bills contain errors, patients should request a detailed, itemized billing audit rather than accepting a summary invoice, ensuring that no services were unbundled or charges for cancelled items were included. By comparing the facility's rates directly to the Medicare benchmark