CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Alton Memorial Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $983
  • Cash Discount Price: $907
  • vs. Medicare Baseline: 9.20x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Alton Memorial Hospital is $983. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $907. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.20x the Medicare baseline. Located in One Memorial Drive, Alton, IL.
Cash / Self-Pay
$907

Average discount available for prompt cash payment at this facility.

Insurance Median
$983

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: $907 (849%)
Insurance Median: $983 (920%)
Cash: $907 (849% of Medicare)
Ins. Median: $983 (920% 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 920% of the Medicare baseline (a markup of 820%). 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 $112 - $1,134 105%
Blue Cross Blue Shield $112 - $1,315 105%
Humana $112 - $1,402 105%
UnitedHealthcare $112 - $1,123 105%
Essence Healthcare [221] $115 108%
Cox Health [757] $118 110%
Devoted Health Plan [847] $118 110%
Medica [662] $118 110%
Cigna $597 - $1,210 559%
Allied Benefits [498] $616 - $1,123 577%
Coresource [497] $616 577%
Fmh Benefit Service Inc [222] $616 577%
Mail Handlers [495] $616 577%
Consociate [478] $694 650%
Sarah Bush Lincoln [636] $694 650%
Healthlink [225] $733 - $1,142 686%
Cox Health Systems Insurance Company [220] $832 - $983 779%
Hope Trust [806] $877 821%
Apwu Health Plan [216] $916 858%
Nalc Health Benefit Plan [242] $916 858%
Priority Health [648] $916 858%
Med-Pay [480] $983 - $1,134 920%
Unicare [568] $983 - $1,142 920%
Healthscope Benefits [258] $1,009 945%
First Health Commercial [734] $1,123 1051%
Beechstreet [551] $1,134 1062%
Detego Health [868] $1,134 1062%
Health Systems Inc [620] $1,134 1062%
Healthcare Sol Mercy [609] $1,134 1062%
Multiplan Commercial [737] $1,134 1062%
Multiplan [240] $1,134 1062%
Phcs [244] $1,134 - $1,210 1062%
Preferred Health Professionals [561] $1,142 1069%
Hfn [563] $1,210 1133%
Medica [661] $1,210 1133%
Health Alliance [224] $1,500 1404%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Memorial Drive, Alton, IL 62002
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals