CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Decatur County Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $1,541
  • Cash Discount Price: $1,541
  • vs. Medicare Baseline: 14.43x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Decatur County Hospital is $1,541. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,541. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 14.43x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$1,541

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,541

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: $1,541 (1443%)
Insurance Median: $1,541 (1443%)
Cash: $1,541 (1443% of Medicare)
Ins. Median: $1,541 (1443% 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 1443% of the Medicare baseline (a markup of 1343%). 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
Wellmark Hmo $480 449%
Wellmark Ppo - All Other Plans $529 495%
Blue Cross Blue Shield $616 577%
Champva -All Plans $867 812%
Everystep Hospice-All Plans $1,002 938%
Aetna $1,040 - $1,522 974%
Tricare $1,040 974%
UnitedHealthcare $1,156 - $1,637 1082%
Benefit Admin System-All Plans $1,252 1172%
Humana $1,406 1316%
Meritain Health-All Plans $1,406 1316%
Misc Commercial-All Plans $1,406 1316%
All Savers-All Plans $1,444 1352%
Allied Benefit System-All Plans $1,444 1352%
American Family Ins Grp-All Plans $1,444 1352%
Rural Carrier Benefit Plan-All Plans $1,483 1388%
Christian Healthcare -All Plans $1,541 1443%
Medica-All Other Plans $1,541 1443%
Golden Rule-All Plans $1,637 1533%
Ntca The Rural Broadband-All Plans $1,637 1533%
Cigna $1,656 1550%
Medical Mutual-All Plans $1,695 1587%
Farm Bureau Financial-All Other Plans $1,733 1623%
Farm Bureau Property And Ca $1,733 1623%
Medi Share-All Plans $1,753 1641%
Uhss-All Plans $1,753 1641%
Health Partners-All Plans $1,772 1659%
Lewermark-All Plans $1,830 1713%
Mail Handlers Benefit-All Plans $1,887 1767%
Midlands Choice-All Plans $1,887 1767%
Priority Health-All Plans $1,926 1803%
Iowa Total Care Mcaid-All Plans $1,965 1840%
Amerigroup Mcaid-All Plans $2,022 1893%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals