CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Norton-King's Daughters' Health

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $811
  • Cash Discount Price: $342
  • vs. Medicare Baseline: 7.59x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Norton-King's Daughters' Health is $811. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $342. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.59x the Medicare baseline. Located in 1373 East Sr 62, Madison, IN.
Cash / Self-Pay
$342

Average discount available for prompt cash payment at this facility.

Insurance Median
$811

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: $342 (320%)
Insurance Median: $811 (759%)
Cash: $342 (320% of Medicare)
Ins. Median: $811 (759% 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 759% of the Medicare baseline (a markup of 659%). 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
Aetna $50 - $1,088 47%
Blue Cross Blue Shield $54 - $811 51%
Humana $54 - $111 51%
Managed Health Services Of Kentucky $54 51%
Passport By Molina $54 51%
Managed Health Services Of Indiana $99 93%
UnitedHealthcare $99 - $1,220 93%
Managed Health Services $115 - $173 108%
Caresource Of Kentucky $156 146%
Caresource Of Indiana $167 156%
Custom Design Benefits $223 - $777 209%
Cigna $1,321 1237%
Encore $1,321 1237%
Quality Care Partners $1,383 1295%
Bluegrass $1,399 1310%
First Health $1,399 1310%
Healthlink $1,399 1310%
Vha/Tristate $1,399 1310%
Multiplan/Phcs $1,430 1339%
Indiana Health Network $1,476 1382%
Siho $1,476 1382%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1373 East Sr 62, Madison, IN 47250
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals