CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $4,303
  • Cash Discount Price: $13,880
  • vs. Medicare Baseline: 40.29x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Central Florida Lake Monroe Hospital is $4,303. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13,880. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 40.29x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$13,880

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,303

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: $13,880 (12995%)
Insurance Median: $4,303 (4029%)
Cash: $13,880 (12995% of Medicare)
Ins. Median: $4,303 (4029% 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 4029% of the Medicare baseline (a markup of 3929%). 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
United $245 - $6,246 229%
Freedom Health $999 935%
Optimum $999 935%
Aetna $1,186 - $4,164 1110%
Avmed $1,695 - $6,940 1587%
Simply $2,137 2001%
Corvel Corporation $2,305 2158%
Prime Health $2,354 2204%
Careworks (Rockport Community) $2,426 2271%
Molina Healthcare $2,637 - $4,441 2469%
Sunshine State Health Plan $3,539 3313%
Plotkin Health $6,940 6498%
Prime Health Sheriff $6,940 6498%
Multiplan $10,410 - $11,798 9746%
Three Rivers Provider Network $10,410 9746%
Ppo Next $11,798 11046%
Novanet $12,492 11696%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals