CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Sonoma Valley Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $3,392
  • Cash Discount Price: $4,957
  • vs. Medicare Baseline: 31.76x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Sonoma Valley Hospital is $3,392. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,957. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 31.76x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$4,957

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,392

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: $4,957 (4641%)
Insurance Median: $3,392 (3176%)
Cash: $4,957 (4641% of Medicare)
Ins. Median: $3,392 (3176% 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 3176% of the Medicare baseline (a markup of 3076%). 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
Tricare $141 132%
Blue Cross Blue Shield $144 - $4,646 135%
Bright Hlth/Brand New Day Mcr Adv $144 135%
Hospice Of Marin-All Plans $144 135%
St Joseph Heritage Hltcare Comm-All Other Plans $144 135%
Veterans Admin-All Plans $144 135%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $151 141%
Cdcr Prison-All Plans $173 162%
Three Rivers (Trpn)-All Plans $173 162%
Chp - Correctional Health Partners - All Plans $187 175%
Bright Hlth/Brand New Day - All Other Plands $194 182%
Wellpath - All Plans $201 188%
Aetna $222 208%
First Health(Coventry)-All Plans $222 208%
Medi-Cal $239 224%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $259 242%
Canopy Health Solutions-All Other Plans $259 242%
Mcal Mgd Care (Php)-All Plans $394 369%
UnitedHealthcare $486 455%
Partnership Healthplan-All Plans $836 783%
Comm Care Network(Ccn)-All Plans $1,000 936%
Healthnet Hmo/Ppo-All Other Plans $2,762 2586%
Blue Shield Ppo-All Plans $4,023 3767%
Kaiser-All Plans $4,603 4310%
Integrated Health Plan-All Plans $5,241 4907%
Interplan-All Plans $5,500 5149%
Champus-All Plans $5,666 5305%
Cigna $5,666 5305%
Networks By Design - All Plans $5,666 5305%
Great West-One Health Plan Ppo/Pos-All Plans $6,020 5636%
Phcs/Multiplan/Beech St-All Plans $6,020 5636%
Bps-All Plans $6,374 5968%
Ppo Alliance-All Plans $6,374 5968%
Pref Health Networl(Phn)-All Plans $6,374 5968%
Meritage Medical Network Op Only Mcare $7,082 6630%
Scan Mcare-All Plans $7,082 6630%
St Joseph Heritage Hltcare Mcr Adv $7,082 6630%
Correct Care Integ Health-All Plans $8,498 7956%
Employer Direct Healthcare-All Plans $8,498 7956%
Meritage Medical Network Op Only-All Other Plans $8,923 8354%
Creative Legal Services-All Plans $9,207 8620%
Canopy Op Only $12,748 11935%
Vnpn - All Plans $12,748 11935%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals