CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Mercyone Waterloo Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $167
  • Cash Discount Price: $1,609
  • vs. Medicare Baseline: 1.56x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Mercyone Waterloo Medical Center is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,609. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.56x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.
Cash / Self-Pay
$1,609

Average discount available for prompt cash payment at this facility.

Insurance Median
$167

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: $1,609 (1506%)
Insurance Median: $167 (156%)
Cash: $1,609 (1506% of Medicare)
Ins. Median: $167 (156% 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.

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 $98 - $573 92%
Medicare (plans) $98 - $103 92%
Blue Cross Blue Shield $99 - $107 93%
Iowa Total Care $100 94%
UnitedHealthcare $100 - $2,476 94%
Medicaid / KanCare $101 - $102 95%
Bcn Domestic $107 100%
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%
Kaiser Domestic $107 100%
Pre-Employment $107 100%
Wc Domestic $107 100%
Amish Hospital Aid $134 125%
Oscar $154 144%
Centivo $167 156%
Ambetter / Centene $169 158%
Claimdoc $202 189%
Nova $202 189%
Geha $240 225%
Allied Benefit Systems $573 536%
Asr Health Benefits $573 536%
Christian Brother Services $573 536%
Coventry $573 536%
First Health $573 536%
Lucent Health $573 536%
Luminare Health $573 536%
Medical Mutual $573 536%
Meritain $573 536%
Webtpa $573 536%
Health Choices $582 545%
Medical Associates $582 545%
Health Partners $1,624 1520%
Auxiant $1,758 1646%
Cigna $1,758 1646%
Medica $1,758 1646%
Midlands $1,758 1646%
Midlands Choice $1,758 1646%
Iowa Dept Of Public Health $2,476 2318%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3421 West Ninth Street, Waterloo, IA 50702
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals