CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Winter Haven Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $2,164
Cash Discount Price: $3,004
vs. Medicare Baseline: 20.26x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Winter Haven Hospital is $2,164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,004. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.26x the Medicare baseline. Located in 200 Ave F Ne, Winter Haven, FL.

Cash / Self-Pay

$3,004

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,164

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: $3,004 (2812%)

Insurance Median: $2,164 (2026%)

Cash: $3,004 (2812% of Medicare)

Ins. Median: $2,164 (2026% 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 2026% of the Medicare baseline (a markup of 1926%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Clear Health Alliance	$68	64%
UnitedHealthcare	$69 - $4,506	65%
Humana	$70 - $133	66%
Freedom Health	$71	66%
Molina Healthcare	$71	66%
Simply Healthcare	$71 - $901	66%
Sunshine Health	$71	66%
Aetna	$72 - $4,081	67%
Florida Community Care	$74	69%
Baycareplus	$107	100%
Blue Cross Blue Shield	$107 - $2,886	100%
Careplus	$113	106%
Solis Health	$117	110%
Freedom	$121	113%
Optimum	$121	113%
Cigna	$123 - $4,356	115%
Health First	$123	115%
Wellcare	$149	140%
Ambetter / Centene	$240 - $5,007	225%
Molina	$901 - $2,959	844%
Ultimate Health Plan	$1,502	1406%
Avmed	$1,552 - $2,453	1453%
Florida Hospital	$2,303	2156%
Evolutions	$2,504 - $4,657	2344%
Multiplan	$4,006	3751%
First Health	$4,256	3985%
United Behavioral Health	$5,007	4688%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $3,004.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72125.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Winter Haven Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72125.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.