CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Valley Children's Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $2,459
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 23.02x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Valley Children's Hospital is $2,459. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 23.02x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,459

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%)
Insurance Median: $2,459 (2302%)
Ins. Median: $2,459 (2302% 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 2302% of the Medicare baseline (a markup of 2202%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
UnitedHealthcare $331 - $844 310%
Allcare Ipa $334 313%
Kaiser $337 - $3,212 316%
Dignity Ipa_Formerly Img $467 437%
La Salle Ipa $467 437%
Sante Ipa $467 437%
Central Valley Medical Providers Ipa $501 - $2,470 469%
Sequoia Health Ipa $501 469%
Univseral Healthcare Ipa $501 469%
United Physicians Network Ipa $517 484%
Community Care Ipa $527 493%
Adventist $589 551%
Blue Cross Blue Shield $605 - $2,360 566%
Cencal Health $660 618%
Kern Family Health Care $667 624%
Central California Alliance For Health $679 636%
Health Net $1,739 - $3,235 1628%
Dignity Health Central Coast $2,448 2292%
Community Health $2,718 2545%
Stanislaus Partners In Health $2,718 2545%
Physicians Choice Medical Group $2,767 2591%
Health Plan Of San Joaquin $2,965 2776%
Fowler Packing $3,063 2868%
Dignity (Formerly Managed Care Systems) $3,113 2915%
Kern Legacy $3,212 3007%
Blue Shield $3,300 - $3,749 3090%
Aetna $3,310 3099%
First Health Formerly Coventry $3,656 3423%
Bakersfield Family Medical Group $3,706 3470%
Network By Design $3,829 3585%
Community Care Health Plan $3,951 3699%
Health Smart $3,953 3701%
Key Medical Ipa $3,953 3701%
Sutter Health $4,200 3932%
Multiplan $4,727 4426%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens