CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Northwest Health-La Porte

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $222
  • Cash Discount Price: $538
  • vs. Medicare Baseline: 2.08x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Northwest Health-La Porte is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $538. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.08x the Medicare baseline. Located in 1007 Lincolnway, La Porte, IN.
Cash / Self-Pay
$538

Average discount available for prompt cash payment at this facility.

Insurance Median
$222

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: $538 (504%)
Insurance Median: $222 (208%)
Cash: $538 (504% of Medicare)
Ins. Median: $222 (208% 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 208% of the Medicare baseline (a markup of 108%). 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
Lutheran $29 - $833 27%
Self Pay $35 - $1,666 33%
Php $44 - $1,274 41%
Lutheran Preferred Medpartners $45 - $1,290 42%
Alpha Baking $48 - $1,388 45%
Php Freedom Network $64 - $1,857 60%
Encore $69 - $2,777 65%
County Of Laporte $75 - $2,160 70%
Cigna $79 - $2,292 74%
Prime Health Services $80 - $2,314 75%
Prime Health Services Auto $80 - $2,314 75%
Aetna $83 - $2,551 78%
Ihn $86 - $2,468 81%
Community Health Alliance $93 - $2,684 87%
Lutheran Network $94 - $2,715 88%
Sagamore Health Network $94 - $2,715 88%
Chandler Group $96 - $2,777 90%
Hfn Workers Compensation $96 - $2,777 90%
Multiplan $96 - $2,777 90%
Phcs $96 - $2,777 90%
UnitedHealthcare $98 - $1,661 92%
Tricare $105 98%
Blue Cross Blue Shield $109 - $451 102%
Humana $109 - $386 102%
Medicare (plans) $109 102%
Node Champva $111 104%
Node Devoted Health Mcr Adv $111 104%
Node Hospice Non Par Agree $111 104%
Node Va $111 104%
Va Choice Program $111 104%
Indiana Dept Of Correction $115 108%
Managed Health Services $115 - $386 108%
Node Pphp Mcr Adv $116 109%
Us Department Of Labor $139 130%
Prime Health In Work Comp $200 187%
In Wc $222 208%
Encore Kba Epo $266 249%
Magnacare Ma $271 254%
One Call $275 257%
Caresource $297 - $386 278%
Encore Kba Ppo $333 312%
Medicaid / KanCare $386 361%
Mhs $386 361%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Lincolnway, La Porte, IN 46350
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals