CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Mercyone Des Moines Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $240
  • Cash Discount Price: $1,498
  • vs. Medicare Baseline: 2.25x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Mercyone Des Moines Medical Center is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,498. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.25x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$1,498

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: $1,498 (1402%)
Insurance Median: $240 (225%)
Cash: $1,498 (1402% 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
Aetna $99 - $800 93%
Iowa Total Care $99 93%
Medicare (plans) $99 - $103 93%
Blue Cross Blue Shield $100 - $107 94%
Medicaid / KanCare $100 94%
UnitedHealthcare $101 - $2,305 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%
Amish Hospital Aid $134 125%
Oscar $143 134%
Centivo $146 137%
Ambetter / Centene $170 159%
Claimdoc $203 190%
Nova $203 190%
Geha $240 225%
Health Choices $463 433%
Medical Associates $463 433%
1199 National Benefit Fund $800 749%
Allied Benefit Systems $800 749%
Asr Health Benefits $800 749%
Christian Brother Services $800 749%
Coventry $800 749%
First Health $800 749%
Lucent Health $800 749%
Luminare Health $800 749%
Medical Mutual $800 749%
Meritain $800 749%
Trustmark Small Business Benefits $800 749%
Webtpa $800 749%
Cigna $1,383 1295%
Health Partners $1,464 1371%
Auxiant $1,498 1402%
Medica $1,498 1402%
Midlands $1,498 1402%
Midlands Choice $1,498 1402%
Usa Managed Care $1,959 1834%
Crime Victim Assistance $2,305 2158%
Iowa Dept Of Public Health $2,305 2158%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 6Th Ave, Des Moines, IA 50314
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals