CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Nemours Childrens Hospital, Florida

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $1,902
  • Cash Discount Price: $4,754
  • vs. Medicare Baseline: 17.81x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Nemours Childrens Hospital, Florida is $1,902. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,754. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 17.81x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.
Cash / Self-Pay
$4,754

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,902

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: $4,754 (4451%)
Insurance Median: $1,902 (1781%)
Cash: $4,754 (4451% of Medicare)
Ins. Median: $1,902 (1781% 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 1781% of the Medicare baseline (a markup of 1681%). 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
Tricare $107 100%
Aetna $630 590%
Truli $729 - $1,902 683%
Avmed $795 744%
Florida Blue $810 - $2,900 758%
Evolutions Healthcare $927 868%
UnitedHealthcare $1,426 1335%
Cigna $1,443 1351%
Employers Health Network Fl $1,902 1781%
Integra Administrative Group $2,852 2670%
Global Medical Management $3,090 2893%
Prime Health Services $3,090 2893%
Star Healthcare Network $3,090 2893%
Velocity $3,566 3339%
First Health Network $3,708 3472%
Pnoa $3,803 3561%
Seminole Tribe Of Fl $3,803 3561%
Private Healthcare Systems $4,374 4095%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6535 Nemours Pkwy, Orlando, FL 32827
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens