CPT 72128
The standard charge for CT scan of thoracic spine without contrast is $1,539.00. However, the price you pay depends on the rate negotiated by your insurance plan and what portion your insurance plan requires you to contribute towards that amount. Enter your info below to start your estimate.
To calculate an estimate of your cost, you will need two things:
LOCATION
79-1019 Haukapila Street, Kealakekua, HI, 96750CONTACT
(808) 322-9311 Visit WebsiteIn compliance with the Centers for Medicare and Medicaid Services (CMS) Final 2020 Price Transparency Rules, effective January 1, 2021, all hospitals in the United States annually must provide a machine-readable file containing negotiated charges (rates) for ALL items and services. Additionally, the rule requires that for 300 shoppable items and services only, hospitals must provide a consumer-friendly display of gross charge and negotiated charges (rates) or estimation tool.
The fees and/or costs provided via this tool are only estimates, and your final bill may be higher or lower than the estimate for various reasons including but not limited to differences in the number of conditions among patients having the same or similar primary procedures, differences in physician ordering practices, unforeseen complications, etc. Moreover, this is not a guarantee of your benefit plan coverage or payment, and the actual payer and patient portion reflected in your final bill may also be higher or lower.
In some instances, where no recent historical claims and/or payment information is available for the payer plan and the item or service you have selected, the estimate may be for the base rate only or not available. Consequently, the estimate may exclude estimates for additional charges and payer payments for services billed in conjunction with the item or service you selected.
Also, this estimate DOES NOT include other services billed for separately by other providers including but not limited to physician or practitioner fees such as pathologist, radiologist, anesthesiologist, physician surgeon or assistant surgeon, etc.
If you have questions about your individual situation or were unable to find an estimate for your upcoming service, please contact us at (808) 322-5813 or email us at [email protected].
Choose a plan to view the insurance rate estimate.
Total estimated charges
$1,539.00Insurance Discount
-$1,415.50Price Negotiated by Insurer
$123.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$7.77HCHG COMPREHENSIVE METABOLIC PROF
$10.56HCHG CT C-SPINE EXT, WO CONTR
$123.50HCHG CT HEAD WO CONTR
$123.50HCHG CT LMBSC SPINE EXT, WO CONTR
$123.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,415.50Price Negotiated by Insurer
$123.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$7.77HCHG COMPREHENSIVE METABOLIC PROF
$10.56HCHG CT C-SPINE EXT, WO CONTR
$123.50HCHG CT HEAD WO CONTR
$123.50HCHG CT LMBSC SPINE EXT, WO CONTR
$123.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$538.65Price Negotiated by Insurer
$1,000.35Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$85.80HCHG COMPREHENSIVE METABOLIC PROF
$109.85HCHG CT C-SPINE EXT, WO CONTR
$1,000.35HCHG CT HEAD WO CONTR
$1,145.95HCHG CT LMBSC SPINE EXT, WO CONTR
$1,000.35This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,403.15Price Negotiated by Insurer
$135.85Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$8.55HCHG COMPREHENSIVE METABOLIC PROF
$11.62HCHG CT C-SPINE EXT, WO CONTR
$135.85HCHG CT HEAD WO CONTR
$135.85HCHG CT LMBSC SPINE EXT, WO CONTR
$135.85This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,344.16Price Negotiated by Insurer
$194.84Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$10.74HCHG COMPREHENSIVE METABOLIC PROF
$14.61HCHG CT C-SPINE EXT, WO CONTR
$194.84HCHG CT HEAD WO CONTR
$139.10HCHG CT LMBSC SPINE EXT, WO CONTR
$177.96This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,384.62Price Negotiated by Insurer
$154.38Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$9.71HCHG COMPREHENSIVE METABOLIC PROF
$13.20HCHG CT C-SPINE EXT, WO CONTR
$154.38HCHG CT HEAD WO CONTR
$154.38HCHG CT LMBSC SPINE EXT, WO CONTR
$154.38This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,415.50Price Negotiated by Insurer
$123.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$7.77HCHG COMPREHENSIVE METABOLIC PROF
$10.56HCHG CT C-SPINE EXT, WO CONTR
$123.50HCHG CT HEAD WO CONTR
$123.50HCHG CT LMBSC SPINE EXT, WO CONTR
$123.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,327.57Price Negotiated by Insurer
$211.43Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$11.28HCHG COMPREHENSIVE METABOLIC PROF
$15.34HCHG CT C-SPINE EXT, WO CONTR
$211.43HCHG CT HEAD WO CONTR
$169.03HCHG CT LMBSC SPINE EXT, WO CONTR
$211.43This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,415.50Price Negotiated by Insurer
$123.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$7.77HCHG COMPREHENSIVE METABOLIC PROF
$10.56HCHG CT C-SPINE EXT, WO CONTR
$123.50HCHG CT HEAD WO CONTR
$123.50HCHG CT LMBSC SPINE EXT, WO CONTR
$123.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$230.85Price Negotiated by Insurer
$1,308.15Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$112.20HCHG COMPREHENSIVE METABOLIC PROF
$143.65HCHG CT C-SPINE EXT, WO CONTR
$1,308.15HCHG CT HEAD WO CONTR
$1,498.55HCHG CT LMBSC SPINE EXT, WO CONTR
$1,308.15This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,415.50Price Negotiated by Insurer
$123.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$7.77HCHG COMPREHENSIVE METABOLIC PROF
$10.56HCHG CT C-SPINE EXT, WO CONTR
$123.50HCHG CT HEAD WO CONTR
$123.50HCHG CT LMBSC SPINE EXT, WO CONTR
$123.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$569.43Price Negotiated by Insurer
$969.57Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$83.16HCHG COMPREHENSIVE METABOLIC PROF
$106.47HCHG CT C-SPINE EXT, WO CONTR
$969.57HCHG CT HEAD WO CONTR
$1,110.69HCHG CT LMBSC SPINE EXT, WO CONTR
$969.57This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$754.11Price Negotiated by Insurer
$784.89Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$67.32HCHG COMPREHENSIVE METABOLIC PROF
$86.19HCHG CT C-SPINE EXT, WO CONTR
$784.89HCHG CT HEAD WO CONTR
$899.13HCHG CT LMBSC SPINE EXT, WO CONTR
$784.89This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,415.50Price Negotiated by Insurer
$123.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$7.77HCHG COMPREHENSIVE METABOLIC PROF
$10.56HCHG CT C-SPINE EXT, WO CONTR
$123.50HCHG CT HEAD WO CONTR
$123.50HCHG CT LMBSC SPINE EXT, WO CONTR
$123.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$46.17Price Negotiated by Insurer
$1,492.83Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$128.04HCHG COMPREHENSIVE METABOLIC PROF
$163.93HCHG CT C-SPINE EXT, WO CONTR
$1,492.83HCHG CT HEAD WO CONTR
$1,710.11HCHG CT LMBSC SPINE EXT, WO CONTR
$1,492.83This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,403.15Price Negotiated by Insurer
$135.85Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$8.55HCHG COMPREHENSIVE METABOLIC PROF
$11.62HCHG CT C-SPINE EXT, WO CONTR
$135.85HCHG CT HEAD WO CONTR
$135.85HCHG CT LMBSC SPINE EXT, WO CONTR
$135.85This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,415.50Price Negotiated by Insurer
$123.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$7.77HCHG COMPREHENSIVE METABOLIC PROF
$10.56HCHG CT C-SPINE EXT, WO CONTR
$123.50HCHG CT HEAD WO CONTR
$123.50HCHG CT LMBSC SPINE EXT, WO CONTR
$123.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,344.16Price Negotiated by Insurer
$194.84Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$10.74HCHG COMPREHENSIVE METABOLIC PROF
$14.61HCHG CT C-SPINE EXT, WO CONTR
$194.84HCHG CT HEAD WO CONTR
$139.10HCHG CT LMBSC SPINE EXT, WO CONTR
$177.96This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,415.50Price Negotiated by Insurer
$123.50Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$7.77HCHG COMPREHENSIVE METABOLIC PROF
$10.56HCHG CT C-SPINE EXT, WO CONTR
$123.50HCHG CT HEAD WO CONTR
$123.50HCHG CT LMBSC SPINE EXT, WO CONTR
$123.50This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.
Total estimated charges
$1,539.00Insurance Discount
-$1,036.73Price Negotiated by Insurer
$502.27Deductible Applied
-Copay
-Coinsurance
-Your insurance company will pay
-You will owe (Estimate)
Some services may incur additional charges based on the exact care required. Listed below are commonly associated charges with this service and the rate negotiated by your insurance plan. These charges are listed to give you an idea of what types of other services are often required, but not all patients will require these specific services.
HCHG CBC W DIFF
$20.09HCHG COMPREHENSIVE METABOLIC PROF
$27.32HCHG CT C-SPINE EXT, WO CONTR
$502.27HCHG CT HEAD WO CONTR
$465.11HCHG CT LMBSC SPINE EXT, WO CONTR
$502.27This calculation is an estimate based on the data that you have entered. For verification of pricing, you need to submit this estimate to Kona Community Hospital so that your price and insurance eligibility can be confirmed.
To verify this rate and discuss any other associated charges to expect, please contact Kona Community Hospital directly at (808) 322-9311.