CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Mercyone Clinton Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $240
  • Cash Discount Price: $2,035
  • vs. Medicare Baseline: 2.25x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Mercyone Clinton Medical Center is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,035. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.25x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$2,035

Average discount available for prompt cash payment at this facility.

Insurance Median
$240

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: $2,035 (1905%)
Insurance Median: $240 (225%)
Cash: $2,035 (1905% of Medicare)
Ins. Median: $240 (225% 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 225% of the Medicare baseline (a markup of 125%). 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
Iowa Total Care $96 90%
Medicaid / KanCare $97 - $98 91%
Bcn Domestic $107 100%
Blue Benefit Administrators Of Massachusetts $107 100%
Blue Care Network $107 100%
Blue Cross Blue Shield $107 - $110 100%
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%
Aetna $109 - $2,739 102%
Medicare (plans) $109 - $114 102%
UnitedHealthcare $111 - $3,130 104%
Amish Hospital Aid $148 139%
Oscar $152 142%
Ambetter / Centene $187 175%
Claimdoc $224 210%
Nova $224 210%
Geha $240 225%
Health Choices $886 830%
Medical Associates $886 830%
Preferred Health Choice $905 847%
The Alliance $1,898 1777%
1199 National Benefit Fund $2,739 2564%
Allied Benefit Systems $2,739 2564%
Asr Health Benefits $2,739 2564%
Christian Brother Services $2,739 2564%
Coventry $2,739 2564%
First Health $2,739 2564%
Lucent Health $2,739 2564%
Luminare Health $2,739 2564%
Medical Mutual $2,739 2564%
Meritain $2,739 2564%
Trustmark Small Business Benefits $2,739 2564%
Webtpa $2,739 2564%
Health Partners $2,745 2570%
Auxiant $2,817 2637%
Cigna $2,817 2637%
Medica $2,817 2637%
Midlands $2,817 2637%
Midlands Choice $2,817 2637%
Multiplan $2,817 2637%
Qualcare $2,817 2637%
Usa Managed Care $2,974 2784%
Crime Victim Assistance $3,130 2930%
Iowa Dept Of Public Health $3,130 2930%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals