CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Mercyone Newton Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $762
  • Cash Discount Price: $1,506
  • vs. Medicare Baseline: 7.13x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Mercyone Newton Medical Center is $762. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,506. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.13x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$1,506

Average discount available for prompt cash payment at this facility.

Insurance Median
$762

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: $1,506 (1410%)
Insurance Median: $762 (713%)
Cash: $1,506 (1410% of Medicare)
Ins. Median: $762 (713% 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 713% of the Medicare baseline (a markup of 613%). 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
Aetna $99 - $2,171 93%
Medicare (plans) $99 - $103 93%
Blue Cross Blue Shield $100 - $107 94%
UnitedHealthcare $101 - $1,321 95%
Blue Benefit Administrators Of Massachusetts $107 100%
Blue Care Network $107 100%
Blue Distinction Transplant $107 100%
Blue Shield - Ca $107 100%
Blue Shield - Id (Regence) $107 100%
Blue Shield - Ny Highmark Northeastern $107 100%
Blue Shield - Ny Highmark Western $107 100%
Blue Shield - Pa (Highmark) $107 100%
Blue Shield - Wa (Regence) $107 100%
Iowa Total Care $121 113%
Medicaid / KanCare $122 114%
Amish Hospital Aid $134 125%
Oscar $143 134%
Centivo $146 137%
Ambetter / Centene $170 159%
Claimdoc $203 190%
Nova $203 190%
Geha $1,321 1237%
Newton Correctional Facility $1,506 1410%
Health Choices $1,749 1637%
Medical Associates $1,749 1637%
Health Partners $2,044 1914%
Auxiant $2,132 1996%
Cigna $2,132 1996%
Health Alliance $2,132 1996%
Medica $2,132 1996%
Midlands $2,132 1996%
Midlands Choice $2,132 1996%
1199 National Benefit Fund $2,171 2033%
Allied Benefit Systems $2,171 2033%
Asr Health Benefits $2,171 2033%
Christian Brother Services $2,171 2033%
Coventry $2,171 2033%
First Health $2,171 2033%
Lucent Health $2,171 2033%
Luminare Health $2,171 2033%
Medical Mutual $2,171 2033%
Meritain $2,171 2033%
Trustmark Small Business Benefits $2,171 2033%
Webtpa $2,171 2033%
Crime Victim Assistance $2,317 2169%
Iowa Dept Of Public Health $2,317 2169%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals