CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Lafayette Regional Health Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $2,424
  • Cash Discount Price: $5,772
  • vs. Medicare Baseline: 22.69x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Lafayette Regional Health Center is $2,424. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,772. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 22.69x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$5,772

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,424

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $5,772 (5404%)
Insurance Median: $2,424 (2269%)
Cash: $5,772 (5404% of Medicare)
Ins. Median: $2,424 (2269% of 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 2269% of the Medicare baseline (a markup of 2169%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
United $60 - $2,597 56%
Healthyblue $61 57%
Aetna $62 - $5,051 58%
Amerigroup $62 58%
Home State Health Plan $62 58%
Medicaid / KanCare $62 58%
Unicare $62 58%
Corvel Corporation $210 - $4,906 197%
Oha Network $212 - $2,886 198%
Ambetter / Centene $1,074 1006%
Nhc Advantage $1,097 1027%
Universal Healthcare $1,501 1405%
Humana $1,951 - $2,482 1827%
Blue Cross Blue Shield $2,193 - $5,772 2053%
College Park Family Care Center $2,482 2324%
Oscar $2,886 2702%
Cigna $3,297 - $4,121 3087%
Wppa Providrs Care Network $4,329 4053%
Multiplan $4,502 4215%
Coventry $4,606 4312%
Coventry Kc Mo $4,606 4312%
Cco, Inc. $4,906 4593%
Focus Healthcare Mgmt, Inc $5,195 4864%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals