CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Franklin General Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $871
Cash Discount Price: $1,857
vs. Medicare Baseline: 8.15x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Franklin General Hospital is $871. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,857. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.15x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$1,857

Average discount available for prompt cash payment at this facility.

Insurance Median

$871

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: $1,857 (1739%)

Insurance Median: $871 (815%)

Cash: $1,857 (1739% of Medicare)

Ins. Median: $871 (815% 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 815% of the Medicare baseline (a markup of 715%). 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
Wellmark Hmo	$480	449%
Wellmark Ppo - All Other Plans	$529	495%
Medical Associates Mcare	$825	772%
Mount Carmel Hp-All Plans	$825	772%
Tricare	$825	772%
UnitedHealthcare	$825 - $1,714	772%
Amerigroup Mcare	$833	780%
Wellmark Mcr Adv	$833	780%
Molina Mcare	$858	803%
Ambetter / Centene	$863 - $1,320	808%
American Hp Iowa - All Plans	$866	811%
Amerigroup Mcaid - All Other Plans	$871	815%
Molina Mcaid - All Other Plans	$876	820%
Centivo - All Plans	$1,238	1159%
Medical Ass Hosp Employer Group	$1,238	1159%
Oscar - All Plans	$1,238	1159%
Midlands Choice-All Plans	$1,444	1352%
Medical Associates Hp-All Other Plans	$1,754	1642%
Preferred Health Choices-All Plans	$1,754	1642%
Splashlight Llc-All Plans	$1,754	1642%
Aetna	$1,919 - $1,960	1797%
Multiplan-All Plans	$1,960	1835%

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 $1,857.
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 Franklin General Hospital 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.