CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $3,403
  • Cash Discount Price: $3,082
  • vs. Medicare Baseline: 31.86x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at HSHS St Elizabeth's Hospital is $3,403. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,082. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 31.86x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$3,082

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,403

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: $3,082 (2885%)
Insurance Median: $3,403 (3186%)
Cash: $3,082 (2885% of Medicare)
Ins. Median: $3,403 (3186% 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 3186% of the Medicare baseline (a markup of 3086%). 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
Molina Healthcare $97 - $124 91%
Meridian Health Plan $102 95%
Aetna $119 - $3,014 111%
Blue Cross Blue Shield $119 - $4,281 111%
Clear Spring Health Of Illinois $119 111%
Health Alliance Medical Plans $119 - $3,639 111%
Health Partners $119 111%
Humana $119 111%
Sae Hospice $119 111%
UnitedHealthcare $119 - $4,281 111%
Celtic Insurance Company $237 222%
Naphcare $257 241%
Hopetrust $285 267%
Claim Doc $297 278%
Amish Community $1,199 1123%
Cigna $2,290 - $4,281 2144%
Wellfirst $2,757 2581%
First Health $3,185 2982%
Healthlink $3,403 - $4,281 3186%
Caterpillar, Inc. $3,438 3219%
Consociate Group $3,767 3527%
Choicecare $3,853 3607%
Healthcare Finest Network (Hfn) $3,853 3607%
Multiplan/Phcs $3,853 3607%
Provider Network Of America $3,853 3607%
City Of Springfield $4,281 4008%
Current Health Solutions $4,281 4008%
Healthscope $4,281 4008%
Illinois Breast And Cervical Cancer Program $4,281 4008%
Interplan $4,281 4008%
Live360 $4,281 4008%
Wexford $4,281 4008%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals