CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: West Valley Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $2,613
Cash Discount Price: $4,377
vs. Medicare Baseline: 24.46x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at West Valley Medical Center is $2,613. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,377. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 24.46x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$4,377

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,613

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: $4,377 (4098%)

Insurance Median: $2,613 (2446%)

Cash: $4,377 (4098% of Medicare)

Ins. Median: $2,613 (2446% 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 2446% of the Medicare baseline (a markup of 2346%). 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
Blue Cross Blue Shield	$38 - $4,158	36%
Molina	$38 - $65	36%
Regence	$219	205%
United	$245 - $2,613	229%
Select Health Idaho (Eirmc Only)	$1,396	1307%
Corizon Health	$1,620	1517%
True Blue	$1,729	1619%
Cigna	$2,451	2295%
Pacificsource Health	$2,613	2446%
Moda	$2,727	2553%
St Luke'S Health Partners	$2,845	2664%
Aetna	$3,462	3241%
Four Rivers Hospice	$3,502	3279%
Multiplan	$3,502	3279%
Humana	$3,677	3443%
Geha Ppo Usa	$3,721	3484%
Coventry First Health	$3,939	3688%
St Alphonsus Health	$3,939	3688%

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 $4,377.
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 West Valley Medical Center 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.