CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Pawhuska Hospital, Inc

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $1,064
Cash Discount Price: $839
vs. Medicare Baseline: 9.96x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Pawhuska Hospital, Inc is $1,064. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $839. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.96x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.

Cash / Self-Pay

$839

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,064

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: $839 (786%)

Insurance Median: $1,064 (996%)

Cash: $839 (786% of Medicare)

Ins. Median: $1,064 (996% 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 996% of the Medicare baseline (a markup of 896%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Healthchoice Ip/Op Only - All Plans	$252	236%
Community Care Comm - All Plans	$267	250%
Blue Cross Blue Shield	$755 - $1,230	707%
Aetna	$839 - $1,447	786%
Tricare	$839	786%
UnitedHealthcare	$839 - $1,042	786%
Wellcare Mcr Adv - All Plans	$839	786%
Humana	$848 - $1,447	794%
Healthcare Highways - All Plans	$941	881%
Cigna	$984	921%
Multiplan - All Plans	$1,085	1016%
Ambetter / Centene	$1,259	1179%
Preferred Commchoice Ip/Op Only - All Plans	$1,302	1219%
Soonerselect Mcaid - All Plans	$1,447	1355%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $839.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72125.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Pawhuska Hospital, Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72125.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.