CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Valor Health

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $1,991
Cash Discount Price: $2,175
vs. Medicare Baseline: 18.64x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Valor Health is $1,991. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,175. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 18.64x the Medicare baseline. Located in 1202 East Locust Street, Emmett, ID.

Cash / Self-Pay

$2,175

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,991

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: $2,175 (2036%)

Insurance Median: $1,991 (1864%)

Cash: $2,175 (2036% of Medicare)

Ins. Median: $1,991 (1864% 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 1864% of the Medicare baseline (a markup of 1764%). 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
Tricare	$1,044	977%
Aetna	$1,076 - $1,912	1007%
Blue Cross Blue Shield	$1,076 - $2,244	1007%
Blue Shield Mcr Adv	$1,076	1007%
Humana	$1,076 - $2,244	1007%
Molina Mcr Adv - All Plans	$1,076	1007%
Regence Bs Triwest - All Plans	$1,076	1007%
UnitedHealthcare	$1,076 - $2,116	1007%
Pacificsource Mcr Adv	$1,130	1058%
Cigna	$2,070 - $2,113	1938%
Moda Health - All Plans	$2,175	2036%
Pacificsource Comm - All Other Plans	$2,175	2036%
Select Health Comm - All Other Plans	$2,175	2036%
Blue Shield Comm - All Other Plans	$6,869	6431%

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 $2,175.
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 Valor Health 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.