CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Adventist Health Tulare

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $134
  • Cash Discount Price: $390
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Adventist Health Tulare is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $390. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.
Cash / Self-Pay
$390

Average discount available for prompt cash payment at this facility.

Insurance Median
$134

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: $390 (365%)
Insurance Median: $134 (125%)
Cash: $390 (365% of Medicare)
Ins. Median: $134 (125% 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.

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
Cigna $26 - $1,816 24%
Blue Shield Mcare $47 - $134 44%
Fhcn Pace Mcr Adv - All Plans $47 - $134 44%
Medicare (plans) $47 - $134 44%
Tricare $47 - $134 44%
UnitedHealthcare $47 - $2,841 44%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot $47 44%
Ah Employee Health Plan - All Plans $52 - $242 49%
Incentive Hlth - All Plans $52 - $242 49%
Hs Interplan-All Plans $59 - $2,628 55%
Cal Forensic Med Grp - All Plans $61 - $175 57%
Healthnet Hmo/Ppo - All Other Plans $69 - $358 65%
Blue Cross Blue Shield $88 - $1,227 82%
Blue Shield Epn $92 - $1,240 86%
Blue Shield-All Other Plans $97 - $1,714 91%
Ccipa Medi-Cal - All Plans $125 - $310 117%
Healthnet Medi-Cal $125 - $313 117%
Medi-Cal $125 - $239 117%
Upn-United Physcn Ntwrk Mcal Profee Only $125 117%
Dignity Mcr Op Only - All Other Plans $134 125%
Prime Health - All Plans $134 125%
Prison Hlthcre - All Plans $172 161%
Aetna $178 - $1,105 167%
Bright Health - All Plans $195 183%
Dignity Mcal Op Only $263 246%
Independence Op Only - All Plans $263 246%
Western Growers - All Plans $1,805 1690%
Network By Design-All Plans $2,746 2571%
Multiplan - All Plans $3,335 3122%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 869 North Cherry Street, Tulare, CA 93274
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals