CT scan, neck (cervical spine)
Facility: Bob Wilson Memorial Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $2,233
- Cash Discount Price: $1,093
- vs. Medicare Baseline: 20.91x 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 2091% of the Medicare baseline (a markup of 1991%). 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 |
|---|---|---|
| Centura Employee Plan | $337 | 316% |
| Blue Cross Blue Shield | $641 | 600% |
| Kansas Health | $875 | 819% |
| Humana | $875 | 819% |
| Medicare (plans) | $875 | 819% |
| Aetna | $875 - $2,187 | 819% |
| UnitedHealthcare | $875 - $2,280 | 819% |
| Multiplan | $2,460 - $2,542 | 2303% |
| Health Partners Of Kansas | $2,569 | 2405% |
| Wppa | $2,597 | 2431% |
Consumer Guidance & Cost Commentary
For the CPT code 72125, representing a CT scan of the neck at Bob Wilson Memorial Hospital in Ulysses, Kansas, the facility's cash median price is $1,093.00, which is significantly lower than the median negotiated rate of $2,233.00. This price transparency data highlights that patients with high-deductible plans or those without insurance may find the cash price more cost-effective than the insurance negotiated rate, as commercial contracts often include administrative overhead that inflates the final bill. While the facility is a Critical Access Hospital owned by a voluntary non-profit church, the cash rate of $1,093.00 remains a key benchmark for consumers to consider before scheduling, especially if their insurance allows for higher negotiated amounts.
When evaluating the financial impact of insurance, it is important to understand that Medicare serves as the objective baseline for pricing, with commercial negotiated rates frequently exceeding Medicare benchmarks by 200% to 300%. For this specific procedure, the Medicare amount is $106.81, illustrating the substantial markup inherent in commercial contracts compared to the federal government's cost-based reimbursement. Patients should be aware that while the hospital offers a cash median of $1,093.00, they may qualify for additional prompt-pay discounts by paying upfront, which can bypass costly claims processing and administrative fees. Furthermore, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, ensuring that the negotiated rates listed here represent the maximum allowable charges rather than unexpected secondary bills.