CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Mayers Memorial Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $965
  • Cash Discount Price: $807
  • vs. Medicare Baseline: 9.03x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Mayers Memorial Hospital is $965. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $807. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.03x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.
Cash / Self-Pay
$807

Average discount available for prompt cash payment at this facility.

Insurance Median
$965

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: $807 (756%)
Insurance Median: $965 (903%)
Cash: $807 (756% of Medicare)
Ins. Median: $965 (903% 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 903% of the Medicare baseline (a markup of 803%). 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
Blue Shield Ca Va $45 - $917 42%
Blue Shield Mcr Adv $45 - $917 42%
Tricare $45 - $965 42%
Health Net Mcr Adv $47 - $965 44%
Arcadian Health Services-All Plans $50 - $965 47%
Imperial Health Plan-All Plans $53 - $1,091 50%
Medi-Cal $125 - $239 117%
Cigna $144 - $1,390 135%
Corvel Ppo-All Plans $144 - $1,390 135%
Coventry/First Health-All Plans $144 - $1,390 135%
Integrated Hp-All Plans $144 - $1,390 135%
Interplan-All Plans $144 - $1,390 135%
Partnership Hp-All Plans $955 894%
Blue Cross Blue Shield $975 - $1,251 913%
Health Net Prison $1,052 985%
Blue Shield Ca Exchange $1,251 1171%
Blue Shield-All Other Plans $1,390 1301%
Hmn-All Plans $1,390 1301%
Multiplan Phcs-All Plans $1,390 1301%
Pfmc-All Plans $1,390 1301%
Superior Ca-All Plans $1,390 1301%
Health Net-All Other Plans $1,456 1363%
Pacificare-All Plans $1,463 1370%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43563 Hwy 299 East, Fall River Mills, CA 96028
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals