CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Children's Healthcare of Atlanta at Scottish Rite

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $2,175
Cash Discount Price: $3,173
vs. Medicare Baseline: 20.36x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Children's Healthcare of Atlanta at Scottish Rite is $2,175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,173. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.36x the Medicare baseline. Located in 1001 Johnson Ferry Road, Atlanta, GA.

Cash / Self-Pay

$3,173

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,175

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: $3,173 (2971%)

Insurance Median: $2,175 (2036%)

Cash: $3,173 (2971% of Medicare)

Ins. Median: $2,175 (2036% 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 2036% of the Medicare baseline (a markup of 1936%). 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
Peachstate [43]	$1,326	1241%
Caresource [61]	$1,362	1275%
Amerigroup [102]	$1,376	1288%
Cigna	$2,097	1963%
Blue Cross Blue Shield	$2,105 - $3,097	1971%
United [5]	$2,105	1971%
Ambetter / Centene	$2,124	1989%
Oscar [228]	$2,126	1990%
Aetna	$2,135	1999%
Caresource Marketplace Bronze/Silver/Gold [60]	$2,156	2019%
Kaiser [6]	$2,160	2022%
Sidecar Health [236]	$2,189	2049%
Direct Employer Agreements [72]	$2,221 - $2,697	2079%
Coventry [9]	$2,227	2085%
Northeast Georgia Heatlh System [808]	$2,380	2228%
Veracity Benefits [809]	$2,380	2228%
First Health [74]	$2,382	2230%
Phcs [93]	$2,697	2525%
Secure Health [340]	$2,697	2525%
Beech Street [71]	$2,856	2674%
Multiplan [92]	$3,110	2912%
Novanet [41]	$3,173	2971%

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 $3,173.
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 Children's Healthcare of Atlanta at Scottish Rite 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.