CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: West Kendall Baptist Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $1,985
  • Cash Discount Price: $3,396
  • vs. Medicare Baseline: 18.58x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at West Kendall Baptist Hospital is $1,985. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,396. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 18.58x the Medicare baseline. Located in 9555 Sw 162 Ave, Miami, FL.
Cash / Self-Pay
$3,396

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,985

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: $3,396 (3179%)
Insurance Median: $1,985 (1858%)
Cash: $3,396 (3179% of Medicare)
Ins. Median: $1,985 (1858% 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 1858% of the Medicare baseline (a markup of 1758%). 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
Amerigroup $65 61%
Medicaid / KanCare $65 - $72 61%
Sunshine State $69 65%
UnitedHealthcare $69 - $5,224 65%
Wellcare $69 65%
Aetna $71 - $4,179 66%
Vista $71 66%
Medicare (plans) $109 - $147 102%
Blue Cross Blue Shield $113 - $3,385 106%
Medica Health Plan $117 110%
Humana $119 111%
Avmed $120 - $2,544 112%
Leon Medical $122 114%
Cigna $124 - $4,179 116%
Non Contracted $1,917 1795%
Amerihealth $2,351 2201%
International $3,396 3179%
Dimension Health Plan $3,918 - $4,702 3668%
Affordable $4,702 4402%
Phcs $4,702 4402%
Quality Health $4,702 4402%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9555 Sw 162 Ave, Miami, FL 33196
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals