CT scan, neck (cervical spine)
Facility: Phelps Memorial Health Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $2,296
- Cash Discount Price: $2,583
- vs. Medicare Baseline: 21.50x 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 2150% of the Medicare baseline (a markup of 2050%). 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 |
|---|---|---|
| UnitedHealthcare | $1,177 - $2,784 | 1102% |
| Aetna | $1,234 - $2,646 | 1155% |
| Blue Cross Blue Shield | $1,234 - $2,726 | 1155% |
| Good Samaritan Mcr Adv - All Plans | $1,234 | 1155% |
| Medica Mcr Adv | $1,234 | 1155% |
| Va Ccn - All Plans | $1,234 | 1155% |
| Wellcare Mcr Adv - All Plans | $1,234 | 1155% |
| Molina Mcaid - All Plans | $1,263 | 1182% |
| Three Rivers - All Plans | $1,481 | 1387% |
| 6 Degrees Hlth - All Plans | $2,296 | 2150% |
| Partners Hlth Alliance - All Plans | $2,296 | 2150% |
| Cpi Benefit Group-All Plans | $2,583 | 2418% |
| Providrs Care/Wppa - All Plans | $2,583 | 2418% |
| Provider Network Of American - All Plans | $2,669 | 2499% |
| Medica-All Other Plans | $2,698 | 2526% |
| Chi Health Partners - All Plans | $2,726 | 2552% |
| Midwest Ntwrk Alliance - All Plans | $2,726 | 2552% |
| First Health - All Plans | $2,729 | 2555% |
| Ambetter / Centene | $3,209 | 3004% |
Consumer Guidance & Cost Commentary
For patients paying out of pocket, the cash median rate for this CT scan of the cervical spine is $2,583. While this amount is higher than the facility's negotiated rate of $2,296 and the median paid rate of $1,888, it is important to note that commercial insurance contracts often result in higher out-of-pocket costs for members who have not met their deductibles. Because the cash price is lower than the negotiated rates paid by major payers like UnitedHealthcare ($2,784 high) and Aetna ($2,646 high), self-pay patients with high-deductible plans may find this direct payment option more cost-effective than relying on insurance, provided they qualify for the self-pay classification.
This procedure is performed at Phelps Memorial Health Center in Holdrege, NE, a voluntary non-profit Critical Access Hospital. The facility's cash rate of $2,583 aligns with the median negotiated rate of $2,583 for several specific payers, including Cpi Benefit Group and Providers Care/Wppa, but remains significantly below the gross chargemaster price of $2,870. To ensure you receive the best possible price, patients should explicitly ask the billing department about "prompt-pay" discounts or self-pay reductions before scheduling, as these upfront incentives can lower the final bill. Additionally, since over 80% of hospital bills contain errors, receiving a detailed, itemized bill is crucial to identifying any unbundled codes or services not rendered, ensuring the final charge reflects the true cost of care rather than inflated summary totals.