CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Northwest Health - Porter

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $386
  • Cash Discount Price: $1,428
  • vs. Medicare Baseline: 3.61x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Northwest Health - Porter is $386. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,428. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.61x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$1,428

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: $1,428 (1337%)
Insurance Median: $386 (361%)
Cash: $1,428 (1337% 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.

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
UnitedHealthcare $98 - $1,295 92%
Veterans Eval Services $98 92%
Tricare $105 98%
Aetna $109 - $2,299 102%
Blue Cross Blue Shield $109 - $451 102%
Humana $109 - $386 102%
Medicare (plans) $109 - $116 102%
Node Mhs Mcr Adv $109 102%
Healthy Indiana Plan $111 104%
Node Devoted Health Mcr Adv $111 104%
Node Hospice Non Par Agree $111 104%
Node Va $111 104%
Care Improvement Plus $114 107%
In Dept Of Correction $115 108%
Node Us Dept Of Labor $138 129%
Align Network $177 166%
One Call Work Comp $177 166%
Encore Health $199 - $3,627 186%
Prime Health $199 - $3,400 186%
Indiana Work Comp $221 207%
Lutheran Preferred $221 - $2,720 207%
Managed Health Services $221 - $386 207%
Node Encore Kba Epo $265 248%
Porter County $265 248%
Preferred Network Access $265 248%
One Call $275 257%
Magnacare Ma $282 264%
Caresource $386 361%
Medicaid / KanCare $386 361%
Mhs $386 361%
Encore Ppo $788 738%
Lutheran Preferred Chs Employees $1,088 1019%
Self Pay $1,224 - $1,632 1146%
Cigna $1,260 1180%
First Health Coventry $1,338 1253%
Physicians Health Plan $1,737 1626%
Php Freedom $1,873 1754%
Sagamore Health Network $2,004 - $2,684 1876%
Southeastem Indiana Health Operations $3,174 - $3,400 2972%
Network Synergy Group $3,400 3183%
Multiplan/Phcs $3,809 3566%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals