CT scan, neck (cervical spine)
Facility: Aurora Medical Center
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $1,014
- Cash Discount Price: $1,470
- vs. Medicare Baseline: 9.49x 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 949% of the Medicare baseline (a markup of 849%). 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 |
|---|---|---|
| Aurora Caregiver | $475 | 445% |
| UnitedHealthcare | $538 - $2,475 | 504% |
| Blue Cross Blue Shield | $556 - $2,499 | 521% |
| Healthpartners | $796 - $2,205 | 745% |
| Molina Exchange | $796 | 745% |
| Common Ground | $812 | 760% |
| Centivo | $820 | 768% |
| Aetna | $836 - $2,428 | 783% |
| Health Payment Systems | $875 | 819% |
| Quartz One | $900 | 843% |
| Everpointe Elite | $983 | 920% |
| Quartz Group | $1,000 | 936% |
| Hs Technology | $1,014 | 949% |
| Wisconsin Physician Service | $1,128 - $1,187 | 1056% |
| Trilogy | $1,170 | 1095% |
| Cigna | $1,700 - $2,487 | 1592% |
| Health Eos Plus | $1,764 | 1652% |
| Health Eos | $2,352 | 2202% |
Consumer Guidance & Cost Commentary
For a CT scan of the cervical spine at Aurora Medical Center in Grafton, WI, the cash median price is $1,470. This facility, a voluntary non-profit acute care hospital in Wisconsin, has a negotiated median rate of $1,014 and a median paid rate of $490. While the cash price is higher than the negotiated rate, patients with high-deductible plans may find the cash option more affordable if their insurance allows out-of-network payments or if the negotiated rate exceeds the cash price due to administrative markups. It is important to verify that your specific plan covers this service before scheduling, as assuming in-network status guarantees the lowest cost can lead to unexpected bills if the contract allows for higher rates.
The Medicare benchmarking rate for this service is $106.81, which serves as a federal baseline for cost transparency. Although the data does not include specific county or state average comparisons for this procedure, the significant gap between the Medicare rate and the facility's cash or negotiated rates highlights the potential for substantial administrative inflation in commercial billing. Patients should request an itemized billing audit to identify any errors, such as unbundled codes or services not rendered, which can occur in over 80% of hospital bills. Additionally, asking for a prompt-pay discount before check-in could reduce the cash balance, as hospitals often offer fee reductions for upfront payments to bypass costly claims processing and administrative overhead.