CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Grandview Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $5,115
  • Cash Discount Price: $2,367
  • vs. Medicare Baseline: 47.89x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Grandview Medical Center is $5,115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,367. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 47.89x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$2,367

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,115

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $2,367 (2216%)
Insurance Median: $5,115 (4789%)
Cash: $2,367 (2216% of Medicare)
Ins. Median: $5,115 (4789% of 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 4789% of the Medicare baseline (a markup of 4689%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Encompass Health $81 76%
Tricare $91 85%
Veterans Eval Services $92 86%
Blue Advantage $94 88%
Humana $94 88%
Medicare (plans) $94 88%
UnitedHealthcare $94 - $5,754 88%
Victory Health $94 88%
Viva Health $94 - $7,033 88%
Select Health $95 89%
Cigna $96 - $170 90%
Hospice $96 90%
Node Champva $96 90%
Node Devoted Health Mcr Adv $96 90%
Node Va $96 90%
Aetna $97 - $3,555 91%
Node Clover Health Mcr Adv $97 91%
Node Wellcare Mcr Adv $98 92%
Node Us Dept Of Labor $120 112%
Ambetter / Centene $143 134%
Medicaid / KanCare $148 139%
Healthspring $167 156%
Blue Cross Blue Shield $201 188%
Choicecare $650 609%
Alamed $1,248 1168%
Self Pay $1,760 - $3,069 1648%
Bp Health Advocate $2,934 - $3,197 2747%
First Health $3,500 - $9,999 3277%
Ag Administrators $4,107 - $4,475 3845%
Drummond $4,107 - $4,475 3845%
American Employee Alliance $4,694 - $5,115 4395%
Healthchoice $5,868 - $7,672 5494%
Value Options $5,868 - $6,394 5494%
Multiplan $7,158 - $8,951 6702%
Blue Bell Creameries $8,214 - $8,951 7690%
Natl Comp Care $8,801 - $9,590 8240%
Usa Ppo $8,801 - $9,590 8240%
Coventry Work Comp Al $9,177 - $9,999 8592%
Novanet $9,476 - $10,326 8872%
Alabama Wc $9,975 - $10,869 9339%
Cal-Med $9,975 - $10,869 9339%
Corvel $9,975 - $10,869 9339%
Associated Admin $10,562 - $11,508 9889%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals