CT scan, neck (cervical spine)
Facility: William Newton Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $557
- Cash Discount Price: $1,548
- vs. Medicare Baseline: 5.21x 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 521% of the Medicare baseline (a markup of 421%). 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 | $456 - $557 | 427% |
| Triwest- All Plans | $541 | 507% |
| UnitedHealthcare | $557 - $1,393 | 521% |
| Ambetter / Centene | $557 - $1,548 | 521% |
| Providrs Care Nexus | $948 | 888% |
| Providrs Care - All Other Plans | $1,084 | 1015% |
Consumer Guidance & Cost Commentary
For the CPT code 72125, representing a CT scan of the cervical spine, the cash price at William Newton Hospital in Winfield, KS, is $1,548. This cash rate is identical to the facility's gross chargemaster and the median amount paid by Medicare, which serves as a reliable benchmark for the true cost of care. While commercial insurance plans like Blue Cross Blue Shield and Triwest-All Plans have negotiated rates ranging from $456 to $557, these amounts are significantly lower than the cash price. However, for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $1,548 upfront may result in lower total costs compared to having insurance pay a negotiated rate that exceeds the cash amount, potentially leaving the patient responsible for the difference through balance billing.
It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network emergency services at in-network facilities, unexpected ancillary charges or non-covered items could still lead to surprise bills. Patients should request a full itemized bill before paying to ensure no unbundled codes or services not rendered are included, as summary bills often obscure these errors. Additionally, because hospitals frequently offer prompt-pay discounts for upfront cash payments, patients should explicitly ask the billing department about self-pay rates or prompt-pay incentives prior to scheduling, as these discounts can reduce the final cost by 20% to 50% and bypass the administrative overhead associated with insurance claims processing.