CT scan, neck (cervical spine)
Facility: Oakleaf Surgical Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $104
- Cash Discount Price: $2,183
- vs. Medicare Baseline: 0.97x 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 |
|---|---|---|
| Blue Cross Blue Shield | $104 - $1,748 | 97% |
| Dean Health Plan | $104 | 97% |
| Group Health Cooperative Of Eau Claire | $104 | 97% |
| Healthpartners | $104 | 97% |
| Humana | $104 | 97% |
| Medica | $104 | 97% |
| Quartz Health Solutions | $104 | 97% |
| Security Health Plan Of Wi | $104 - $876 | 97% |
| Ucare Wi | $104 | 97% |
| UnitedHealthcare | $104 | 97% |
| Alliance | $518 | 485% |
Consumer Guidance & Cost Commentary
For this CT scan of the cervical spine at Oakleaf Surgical Hospital in Altoona, WI, the facility's cash median rate of $2,183 is significantly higher than the Medicare benchmark of $106.81, illustrating a substantial markup typical of commercial pricing structures. While the hospital's gross charge is listed at $2,426, the actual cash payment for patients without insurance is $2,183, which remains well above the federal government's calculated cost basis for this procedure.
Insurance coverage varies widely among the 11 payers, with negotiated rates ranging from a low of $104 to a high of $1,748 depending on the specific plan. For instance, Blue Cross Blue Shield members may face a range between $1,748 and $104, whereas plans like Alliance and Dean Health Plan have a fixed negotiated rate of $518 and $104, respectively. Because the cash price of $2,183 is lower than the maximum negotiated rate for some insurers, patients with high-deductible plans might save money by paying out-of-pocket directly. To confirm the best possible price, consumers should verify their specific plan's allowed amount and ask the hospital about any available self-pay or prompt-pay discounts before scheduling.