CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Elkhart General Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $1,487
Cash Discount Price: $1,611
vs. Medicare Baseline: 13.92x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Elkhart General Hospital is $1,487. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,611. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.92x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.

Cash / Self-Pay

$1,611

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,487

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: $1,611 (1508%)

Insurance Median: $1,487 (1392%)

Cash: $1,611 (1508% of Medicare)

Ins. Median: $1,487 (1392% 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 1392% of the Medicare baseline (a markup of 1292%). 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
Mclaren (Mi	$60	56%
UnitedHealthcare	$60 - $1,666	56%
Aetna	$111 - $1,678	104%
Blue Cross Blue Shield	$111 - $610	104%
Humana	$111 - $1,735	104%
Pace	$111	104%
Devoted Healthcare	$117 - $496	110%
Plain Church	$167 - $1,983	156%
Caresource	$178 - $3,223	167%
Mhs	$201 - $3,223	188%
Mdwise	$386 - $3,223	361%
Cha	$1,487 - $1,934	1392%
Immergrun	$1,487 - $1,983	1392%
Php	$1,611 - $1,735	1508%
Cigna	$1,785 - $1,884	1671%
Multiplan	$1,785	1671%
Signature	$1,810	1695%
Encore	$1,834	1717%
Heartland	$2,479	2321%

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 $1,611.
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 Elkhart General Hospital 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.