CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Scripps Memorial Hospital La Jolla

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $414
  • Cash Discount Price: $1,725
  • vs. Medicare Baseline: 3.88x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Scripps Memorial Hospital La Jolla is $414. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,725. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.88x the Medicare baseline. Located in 9888 Genesee Avenue, La Jolla, CA.
Cash / Self-Pay
$1,725

Average discount available for prompt cash payment at this facility.

Insurance Median
$414

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: $1,725 (1615%)
Insurance Median: $414 (388%)
Cash: $1,725 (1615% of Medicare)
Ins. Median: $414 (388% 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 388% of the Medicare baseline (a markup of 288%). 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
Mpmg Mcr Adv [836] $78 73%
Mpmg [800] $78 73%
Ocn Mcr Adv [890] $78 73%
UnitedHealthcare $78 - $1,311 73%
Aetna $100 - $1,394 94%
Astiva Mcr Adv [464] $134 125%
Bc Mcr Adv [830] $134 125%
Blue Cross Blue Shield $134 - $1,311 125%
Bs Mcr Adv [829] $134 125%
Central Health Mcr Adv [441] $134 125%
Cigna $134 - $414 125%
Clever Care Mcr Adv [465] $134 125%
D-Snp Mcr Adv [889] $134 125%
Dsnp/Csnp - Generic [458] $134 125%
Family Health Centers Pace Mcr Adv Hmo [556] $134 125%
Family Health Centers Pace Medi-Cal [555] $134 125%
Gary And Mary West Pace Medi-Cal Hmo [557] $134 125%
Gpmg/Altura - Mcr Adv [888] $134 125%
Hn Mcr Adv [832] $134 125%
Humana $134 125%
Integrated Health Partners - Mcr Adv [895] $134 125%
Kaiser Northern Ca Region Mcr Adv [386] $134 125%
La Care Mcr Adv Hmo [612] $134 125%
Medicare (plans) $134 125%
San Diego Pace Medi-Cal [553] $134 125%
Scan Mcr Adv [835] $134 125%
Scan [500] $134 125%
Scan [818] $134 125%
Sharp Comm Med Grp Mcr Adv [840] $134 125%
Sharp Health Plan Mcr Adv [531] $134 125%
Sharp Health Plan Mcr Adv [897] $134 125%
Sharp Rees Stealy Med Grp Mcr Adv [841] $134 125%
St Paul'S Pace Medi-Cal [551] $134 125%
Ucsd Mcr Adv [873] $134 125%
Uh Mcr Adv [831] $134 125%
Uh Palomar Health Mcr Adv [885] $134 125%
Alignment Health Plan [443] $138 129%
Sharp Comm Med Grp [812] $207 - $1,394 194%
Sharp Rees Stealy Med Grp [811] $207 - $1,394 194%
Ucsd [807] $207 - $1,394 194%
Health Net [340] $214 - $1,228 200%
Prime Healthcare [614] $229 214%
Prospect Med Group [893] $235 220%
Mc Alignment [917] $414 388%
Mc Blue Shield Promise Health Plan [914] $414 388%
Mc Blue Shield [902] $414 388%
Mc Health Net [904] $414 388%
Mc Scan [905] $414 388%
Mc United [906] $414 388%
Radys Cpmg [803] $552 517%
Blue Shield [230] $1,070 - $1,159 1002%
Bs [816] $1,118 - $1,159 1047%
Imperial County Phys Med Group [855] $1,118 - $1,194 1047%
Bc [814] $1,194 1118%
Integrated Health Partners [894] $1,194 1118%
Perlman Med Group [899] $1,194 1118%
Hn [815] $1,228 1150%
Centivo [581] $1,242 1163%
Uh [819] $1,311 1227%
Palomar Health [892] $1,394 1305%
Veba Med Grp [813] $1,394 1305%
Kaiser Northern Ca Region Hmo/Ppo [384] $2,629 2461%
Kaiser [380] $2,629 2461%
Kaiser [383] $2,629 2461%
Rady Children'S Hospital [825] $2,829 2649%
Multi Plan Network [470] $4,899 4587%
First Health Network [330] $5,175 4845%
Pnoa [615] $5,175 4845%
Choice Care Network [270] $5,520 5168%
Healthsmart [350] $5,520 5168%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9888 Genesee Avenue, La Jolla, CA 92037
  • CMS Rating: ★★★★★
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals