CT scan, neck (cervical spine)
Facility: Children'S Mercy South
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $119
- Cash Discount Price: $988
- vs. Medicare Baseline: 1.11x 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.
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 |
|---|---|---|
| UnitedHealthcare | $41 - $2,659 | 38% |
| Healthy Blue | $43 - $273 | 40% |
| Medicaid / KanCare | $44 - $70 | 41% |
| Home State Health | $50 - $240 | 47% |
| Cigna | $53 - $2,750 | 50% |
| Wppa Providrs Care | $61 - $2,572 | 57% |
| Healthlink | $61 - $3,482 | 57% |
| Health Midwest Comprehensive Care | $64 - $2,576 | 60% |
| American Healthcare Alliance | $67 - $3,363 | 63% |
| Quiktrip | $82 - $2,576 | 77% |
| Wellfit/Centrus | $89 - $2,572 | 83% |
| Centivo | $92 - $2,572 | 86% |
| Medica | $92 - $2,307 | 86% |
| Nebraska Furniture Mart | $94 - $2,572 | 88% |
| Humana | $98 - $2,631 | 92% |
| Orscheln | $99 - $2,572 | 93% |
| Blue Cross Blue Shield | $102 - $2,928 | 95% |
| Multiplan | $102 - $3,007 | 95% |
| Aetna | $104 - $2,691 | 97% |
| Mercy Health | $115 - $2,968 | 108% |
| Coxhealth Network | $117 - $2,928 | 110% |
| Coventry Health Care Of Kansas | $132 - $2,928 | 124% |
| National Preferred Provider Network | $139 - $3,561 | 130% |
Consumer Guidance & Cost Commentary
For the CT scan of the cervical spine at Children's Mercy South in Overland Park, Kansas, the facility's cash median price is $988.00, which is significantly lower than the gross charge of $2,058.00. While commercial insurance plans negotiate rates that typically range from $41 to $3,561 depending on the carrier, these negotiated amounts often exceed the cash price. For patients with high-deductible plans, paying the cash median directly can be more cost-effective than relying on insurance, as the insurer's allowed amount may still be higher than the out-of-pocket cash rate. To maximize savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as hospitals often offer a 20% to 50% reduction for upfront payment that bypasses the administrative costs of claims processing.
The facility's pricing is benchmarked against Medicare, which sets a fixed reimbursement rate of $106.81 for this procedure. The cash median of $988.00 represents a markup of 1.1 times the Medicare amount, reflecting the facility's cost structure and local wage index. Although the data does not provide specific state or county average comparisons for this specific code, the wide variance in negotiated rates across 23 payers—ranging from a low of $41 with UnitedHealthcare to a high of $3,561 with National Preferred Provider Network—highlights the importance of verifying individual plan allowed amounts. Patients should avoid accepting summary bills and instead request a detailed, itemized statement to ensure no unbundled codes or services not rendered are included, as over 80% of