CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Grossmont Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $2,805
Cash Discount Price: $3,171
vs. Medicare Baseline: 26.26x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Grossmont Hospital is $2,805. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,171. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 26.26x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$3,171

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,805

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: $3,171 (2969%)

Insurance Median: $2,805 (2626%)

Cash: $3,171 (2969% of Medicare)

Ins. Median: $2,805 (2626% 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 2626% of the Medicare baseline (a markup of 2526%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Molina	$25	23%
San Diego Pace	$634 - $4,143	594%
Indian Health Council	$740 - $2,537	693%
Blue Cross Blue Shield	$1,184 - $3,171	1109%
California Health And Wellness	$1,184	1109%
Aetna	$1,256 - $3,382	1176%
Interplan	$1,256	1176%
Blue Shield	$1,438 - $3,171	1346%
Kaiser	$1,438 - $2,325	1346%
Allianz Global Assistance	$2,114 - $3,171	1979%
Health Net	$2,355 - $2,960	2205%
Medicare (plans)	$2,355	2205%
UnitedHealthcare	$2,389 - $2,960	2237%
Medi-Cal	$2,697 - $4,143	2525%
Humana	$2,805 - $2,875	2626%
County Medical Services	$2,875 - $2,960	2692%
Cigna	$2,917 - $3,171	2731%
Multiplan	$3,467	3246%
Community Health Group	$4,143 - $18,827	3879%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $3,171.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72125.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grossmont Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72125.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.