CT scan, neck (cervical spine)
Facility: Susan B Allen Memorial Hospital
Billing Code: 72125 (CPT)
- CPT Billing Code: 72125
- Insurance Median: $635
- Cash Discount Price: $741
- vs. Medicare Baseline: 5.95x 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 595% of the Medicare baseline (a markup of 495%). 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 | $350 | 328% |
| Providrs Care | $919 | 860% |
Consumer Guidance & Cost Commentary
For a CT scan of the neck at Susan B Allen Memorial Hospital in El Dorado, KS, the facility's cash median price is $741.00, which is notably lower than the negotiated rates charged by UnitedHealthcare ($350) and Providrs Care ($919). While the hospital's cash rate is higher than the Medicare benchmark of $106.81, it remains significantly below the gross chargemaster price of $1,140.00. Patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $741.00, as paying out-of-pocket could result in immediate savings compared to the administrative overhead embedded in commercial contracts.
The facility's negotiated rates of $350 and $919 are substantially higher than the cash price, illustrating how insurance contracts often include administrative costs that inflate the baseline price by 20% to 40%. Before scheduling, it is crucial to verify your specific plan's allowed amount, as in-network status does not guarantee the lowest possible price; some facilities charge significantly more than others for the same service. Additionally, if you choose to pay directly, ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% when paid upfront, bypassing the costly claims processing cycle that insurance billing requires.