CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Lower Keys Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $227
  • Cash Discount Price: $1,886
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Lower Keys Medical Center is $227. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,886. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.13x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$1,886

Average discount available for prompt cash payment at this facility.

Insurance Median
$227

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: $1,886 (1766%)
Insurance Median: $227 (213%)
Cash: $1,886 (1766% of Medicare)
Ins. Median: $227 (213% 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 213% of the Medicare baseline (a markup of 113%). 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
UnitedHealthcare $62 - $4,678 58%
Veterans Eval Services $100 94%
Florida Childrens Medical Services $103 96%
Medicaid / KanCare $103 - $113 96%
South Florida Community Care Network $103 96%
Humana $106 - $115 99%
Tricare $111 104%
Amerigroup $113 106%
Positive Healthcare $113 106%
Simply Healthcare $113 - $1,886 106%
Wellcare $113 106%
Wellcare Healthease $113 106%
Blue Cross Blue Shield $115 - $5,861 108%
Medicare (plans) $115 108%
Ultimate Health $115 108%
Molina $116 109%
Node Champva $117 110%
Node Non Par Hospice Agree $117 110%
Node United Behavioral Va Ccn $117 110%
Node Va $117 110%
Prestige Health Choice $119 111%
Magellan $123 115%
Correct Care Solutions $129 121%
Node Us Dept Of Labor $146 137%
Prime Health Work Comp Fl $213 199%
Fl Work Comp $220 206%
Heritage Summit Work Comp Fl $220 206%
State Auto Insurance Fl $234 219%
Self Pay $1,643 - $2,129 1538%
Cigna $3,589 3360%
Aetna $4,246 3975%
Monroe County $4,563 4272%
Evolutions Healthcare Systems $4,867 - $5,780 4557%
Keys Energy $4,867 4557%
Prime Health Ppo $4,867 4557%
Avmed Health Plan $5,171 4841%
Direct Healthcare $6,084 5696%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals