CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: San Antonio Regional Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $362
  • Cash Discount Price: $1,243
  • vs. Medicare Baseline: 3.39x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at San Antonio Regional Hospital is $362. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,243. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.39x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$1,243

Average discount available for prompt cash payment at this facility.

Insurance Median
$362

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: $1,243 (1164%)
Insurance Median: $362 (339%)
Cash: $1,243 (1164% of Medicare)
Ins. Median: $362 (339% 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 339% of the Medicare baseline (a markup of 239%). 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 $132 124%
Blue Shield Mcr Adv $134 125%
Caremore Mcr Adv - All Plans $134 125%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $134 125%
Healthnet Mcr Adv $134 125%
Humana $134 125%
Iehp Mcr Adv $134 125%
Inter Valley Hp Mcr Adv- All Plans $134 125%
Kindred Mcr Adv-All Plans $134 125%
Molina Mcr Adv $134 125%
Scan Health Plan Mcr Adv-All Plans $134 125%
Universal Care - All Plans $134 125%
Blue Cross Blue Shield $137 - $5,560 128%
Zelis Mcr Adv $141 132%
Kasiser Mcr Adv $144 135%
Imperial Health Mcr Adv-All Plans $148 139%
Choice Phycn Ntwrk Op Only $168 157%
Molina Exchange-All Other Plans $175 164%
Aetna $182 - $10,230 170%
Iehp Comm - All Other Plans $195 183%
Redlands Employee $202 189%
Redlands Hmo-All Other Plans $210 197%
Prime Health - All Plans $235 220%
Medi-Cal $239 224%
Kaiser Medi-Cal $251 235%
Healthnet Medi-Cal $252 236%
Alpha Care Mg Mcal/Hlthy Kids $263 246%
Heritage Prov Ntwrk/Regal Mcal $263 246%
Molina Medi-Cal $275 257%
Iehp Mcal $310 290%
UnitedHealthcare $316 - $1,345 296%
Healthnet - All Other Plans $322 301%
Pc Inland Valley Scan $362 339%
Pc Inland Valley-All Other Plans $362 339%
Kaiser Comm - All Other Plans $375 351%
Blue Shield Epn $420 393%
Choicecare Ntwrk-All Plans $550 515%
Coventry Ccn/First Hlth - All Plans $1,200 1123%
Ambetter / Centene $1,862 1743%
Epic Health Plan - All Other Plans $3,069 2873%
Blue Shield Epo Ppo - All Other Plans $3,244 3037%
Blue Shield Hmo Pos / Calpers Ppo $3,244 3037%
Multiplan/Phcs - All Plans $7,366 6896%
Networks By Design - All Plans $7,672 7183%
Zelis Comm-All Other Plans $7,672 7183%
Foundation Inland Epo-All Other Plans $8,184 7662%
Foundation Inland Ppo $8,696 8142%
Health Payors - All Plans $9,207 8620%
Interplan - All Plans $9,207 8620%
Wellcare/Easy Choice-All Plans $10,025 9386%
Alpha Care Mg Mcr Adv $10,230 9578%
Central Hlth Plan Mcr Adv-All Plans $10,230 9578%
Epic Health Plan Mcr Adv $10,230 9578%
Prospect Hp-All Plans $10,230 9578%
Providence Clevercare Mcr Adv $10,230 9578%
Heritage Prov Ntwrk/Regal Mcr Adv $10,383 9721%
Clever Care Mcr Adv - All Plans $10,742 10057%
La Salle Hp Mcr Adv-All Plans $10,742 10057%
Providence Oscar-All Other Plans $10,742 10057%
Alpha Care Mg-All Other Plans $12,788 11973%
Heritage Prov Ntwrk/Regal - All Other Plans $18,798 17599%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals