CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Methodist Hospitals Inc

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $386
Cash Discount Price: $2,745
vs. Medicare Baseline: 3.61x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Methodist Hospitals Inc is $386. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,745. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.61x the Medicare baseline. Located in 600 Grant St, Gary, IN.

Cash / Self-Pay

$2,745

Average discount available for prompt cash payment at this facility.

Insurance Median

$386

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: $2,745 (2570%)

Insurance Median: $386 (361%)

Cash: $2,745 (2570% of Medicare)

Ins. Median: $386 (361% 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 361% of the Medicare baseline (a markup of 261%). 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
Aetna	$110 - $2,902	103%
Blue Cross Blue Shield	$110 - $3,453	103%
Humana	$110 - $386	103%
Medicare (plans)	$110	103%
United Heathcare	$110	103%
Zing	$112	105%
Caresource Maketplace	$182	170%
Ambetter / Centene	$220	206%
Physicians Health Plan Of Northern Indiana	$330	309%
Caresource	$386	361%
Managed Health Services	$386	361%
Medicaid / KanCare	$386	361%
UnitedHealthcare	$386 - $572	361%
Magnacare	$523	490%
Cigna	$1,506 - $1,635	1410%
Encore	$2,353 - $3,491	2203%
Phcs	$2,667	2497%
Siho	$2,745	2570%
Sagamore	$2,824	2644%
Multiplan	$2,863	2680%
Hfn	$3,059 - $3,334	2864%

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 $2,745.
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 Methodist Hospitals Inc 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.