CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Decatur Memorial Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $1,302
  • Cash Discount Price: $4,546
  • vs. Medicare Baseline: 12.19x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Decatur Memorial Hospital is $1,302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,546. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.19x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.
Cash / Self-Pay
$4,546

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,302

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: $4,546 (4256%)
Insurance Median: $1,302 (1219%)
Cash: $4,546 (4256% of Medicare)
Ins. Median: $1,302 (1219% 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 1219% of the Medicare baseline (a markup of 1119%). 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
Commercial Workers Compensation $11 - $1,309 10%
Hfn $11 - $3,410 10%
Blue Cross Blue Shield $103 - $4,546 96%
Aetna $110 - $3,050 103%
Coventry $110 - $2,305 103%
Health Alliance $110 - $3,023 103%
Humana $110 - $988 103%
Medicare (plans) $110 - $122 103%
UnitedHealthcare $110 - $4,546 103%
Veterans Administration $110 - $122 103%
Wellcare $110 103%
Tricare $112 - $124 105%
Medicaid / KanCare $134 - $137 125%
Plain Church Medical Group $136 - $2,046 127%
Caterpillar $252 236%
Illinois Workers Compensation $1,079 - $1,378 1010%
Cigna $1,216 - $2,118 1138%
Mennonite Churches $1,591 1490%
Health Alliance Mh Employee Plan $2,091 1958%
6 Degrees Health $2,728 2554%
Hopetrust $2,728 2554%
Hst $2,728 2554%
Phcs Savility $2,955 2767%
Phcs Multiplan Ppo $3,091 2894%
Healthlink $3,119 2920%
Corvel $3,273 3064%
Consociate $3,364 3150%
Liability $4,546 4256%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 North Edward Street, Decatur, IL 62526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals