CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Adventist Health Vallejo

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $3,626
  • Cash Discount Price: $1,051
  • vs. Medicare Baseline: 33.95x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Adventist Health Vallejo is $3,626. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,051. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 33.95x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.
Cash / Self-Pay
$1,051

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,626

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: $1,051 (984%)
Insurance Median: $3,626 (3395%)
Cash: $1,051 (984% of Medicare)
Ins. Median: $3,626 (3395% 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 3395% of the Medicare baseline (a markup of 3295%). 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
Cigna $26 - $6,579 24%
Blue Shield Mcr Adv $46 - $106 43%
Medicare (plans) $46 - $106 43%
Napa County Mcal Child $46 - $106 43%
Tricare $46 - $106 43%
Ah Employee Health Plan-All Plans $51 - $191 48%
Interplan-All Plans $56 - $5,346 52%
Kaiser-All Plans $56 - $6,908 52%
UnitedHealthcare $62 - $5,243 58%
Blue Shield Non-Epn-All Other Plans $64 - $3,816 60%
Western Growers-All Plans $68 - $4,359 64%
Aetna $69 - $1,270 65%
Va Mcr-All Other Plans $106 99%
Phcs-All Plans $113 - $4,523 106%
Medi-Cal $125 - $239 117%
Health Management Network-All Plans $174 - $6,990 163%
Three Rivers-All Plans $184 - $7,402 172%
Va Medi-Cal $239 224%
Blue Cross Blue Shield $1,005 - $1,205 941%
Healthnet-All Plans $1,060 992%
Blue Shield Behav Hlth $2,644 - $3,701 2475%
Blue Shield Epn $2,767 - $3,874 2591%
Choicecare-All Plans $4,112 - $5,757 3850%
Beech Street-All Plans $4,406 - $6,168 4125%
Galaxy Network-All Plans $5,288 - $7,402 4951%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 Oregon St, Vallejo, CA 94590
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Psychiatric