CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: St Francis Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $554
  • Cash Discount Price: $1,932
  • vs. Medicare Baseline: 5.19x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at St Francis Hospital is $554. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,932. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.19x the Medicare baseline. Located in 7Th and Clayton Sts, Wilmington, DE.
Cash / Self-Pay
$1,932

Average discount available for prompt cash payment at this facility.

Insurance Median
$554

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: $1,932 (1809%)
Insurance Median: $554 (519%)
Cash: $1,932 (1809% of Medicare)
Ins. Median: $554 (519% 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 519% of the Medicare baseline (a markup of 419%). 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
Pace-Trinity Health $109 102%
Saint Francis Life $109 102%
Blue Cross Blue Shield $111 - $1,162 104%
Cigna $112 - $1,840 105%
Medicare (plans) $114 - $117 107%
Blue Shield - De (Highmark) Medciare Advantage $115 108%
Highmark Health Options Dual Plan $115 108%
Aetna $118 - $1,932 110%
Coventry $134 125%
Delaware First Health $178 - $275 167%
Blue Benefit Administrators Of Massachusetts $554 519%
Blue Care Network $554 519%
Blue Distinction Transplant $554 519%
Blue Shield - Ca $554 519%
Blue Shield - Id (Regence) $554 519%
Blue Shield - Ny Highmark Northeastern $554 519%
Blue Shield - Ny Highmark Western $554 519%
Blue Shield - Pa (Highmark) $554 519%
Blue Shield - Wa (Regence) $554 519%
Medicaid / KanCare $1,041 975%
Meritain $1,932 1809%
Trustmark Small Business Benefits $1,932 1809%
Devon Health Services $2,824 2644%
Galaxy Health Network $2,824 2644%
Multiplan $2,824 2644%
Prime Health Services $2,824 2644%
Three Rivers Provider Network $2,824 2644%
Wc Corvel $2,824 2644%
Geha $2,854 2672%
UnitedHealthcare $2,854 2672%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7Th and Clayton Sts, Wilmington, DE 19805
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals