CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Sierra View Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $716
Cash Discount Price: $1,791
vs. Medicare Baseline: 6.70x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Sierra View Medical Center is $716. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,791. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.70x the Medicare baseline. Located in 465 W Putnam Ave, Porterville, CA.

Cash / Self-Pay

$1,791

Average discount available for prompt cash payment at this facility.

Insurance Median

$716

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: $1,791 (1677%)

Insurance Median: $716 (670%)

Cash: $1,791 (1677% of Medicare)

Ins. Median: $716 (670% 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 670% of the Medicare baseline (a markup of 570%). 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
Blue Cross Blue Shield	$125 - $1,000	117%
Dignity Health	$125 - $161	117%
Lasalle	$125 - $134	117%
Healthnet	$132 - $1,919	124%
Humana	$134	125%
Aetna	$1,663	1557%
Kaiser	$1,791	1677%
Multiplan	$1,970 - $2,175	1844%
Healthsmart	$2,175	2036%
Blue Shield	$2,282	2137%
Cigna	$2,303	2156%

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 $1,791.
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 Sierra View Medical Center 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.