CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Fayette County Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $257
  • Cash Discount Price: $2,201
  • vs. Medicare Baseline: 2.41x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Fayette County Hospital is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,201. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.41x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.
Cash / Self-Pay
$2,201

Average discount available for prompt cash payment at this facility.

Insurance Median
$257

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: $2,201 (2061%)
Insurance Median: $257 (241%)
Cash: $2,201 (2061% of Medicare)
Ins. Median: $257 (241% 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 241% of the Medicare baseline (a markup of 141%). 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
Health Alliance Mcare $47 - $1,319 44%
Healthlink Mcr Adv $47 - $1,319 44%
Aetna $50 - $2,843 47%
Cigna $53 - $3,091 50%
Coventry/Ghp-All Plans $63 - $2,679 59%
Multiplan - All Plans $86 - $3,503 81%
Health Alliance - All Other Plans $93 - $3,404 87%
Blue Cross Blue Shield $109 - $3,462 102%
Illinicare - All Plans $210 - $257 197%
Medicaid / KanCare $210 - $257 197%
Meridian-All Plans $210 - $257 197%
UnitedHealthcare $233 - $3,420 218%
Healthlink Hmo $242 - $2,885 227%
Healthlink Ppo - All Other Plans $242 - $3,297 227%
Humana $1,319 1235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 650 W Taylor St, Vandalia, IL 62471
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals