CT
What goes into a price?
Negotiated prices across insurers
Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.
Procedures included in this package
This list includes the services and fees bundled into the CT Standard Service Package (SSP RA001). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.
| Code | Code Type | Description |
|---|---|---|
| HCPCS 72125 | Professional Fee | CT scan of cervical spine without contrast |
| HCPCS 72132 | Professional Fee | CT Scan of Lower Spine with Contrast Dye |
| HCPCS 72129 | Facility Fee | CT Scan of Thoracic Spine with Contrast Agent Injection |
| HCPCS 72129 | Professional Fee | CT Scan of Thoracic Spine with Contrast Agent Injection |
| HCPCS Q9967 | Facility Fee | Non-ionic low osmolar contrast, 300-399mg/ml iodine concentration per ml |