CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Northwest Health - Starke

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $237
  • Cash Discount Price: $446
  • vs. Medicare Baseline: 2.22x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Northwest Health - Starke is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $446. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.22x the Medicare baseline. Located in 102 E Culver Rd, Knox, IN.
Cash / Self-Pay
$446

Average discount available for prompt cash payment at this facility.

Insurance Median
$237

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: $446 (418%)
Insurance Median: $237 (222%)
Cash: $446 (418% of Medicare)
Ins. Median: $237 (222% 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 222% of the Medicare baseline (a markup of 122%). 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 $29 - $1,697 27%
Medpartners $36 - $1,034 34%
Physicians Health Plan $44 - $1,274 41%
Alpha Baking $48 - $1,388 45%
Php $64 - $1,857 60%
Encore $69 - $2,684 65%
UnitedHealthcare $75 - $2,184 70%
Multiplan Inc $86 - $2,777 81%
Aetna $87 - $2,669 81%
Cigna $89 - $2,561 83%
Coventry First Health $92 - $2,669 86%
Lutheran Network $94 - $2,715 88%
Sagamore Health Network $94 - $2,715 88%
Community Health Alliance $96 - $2,777 90%
Ppom $100 - $2,900 94%
Tricare $105 98%
Managed Health Services $107 - $386 100%
Node Champva $111 104%
Blue Cross Blue Shield $117 - $447 110%
Humana $117 - $386 110%
Medicare (plans) $117 110%
Node Hospice Non Par Agree $118 110%
Node Va $118 110%
Node Devoted Health Mcr Adv $119 111%
In Dept Of Correction $123 115%
Node Pphp Mcr Adv $124 116%
Us Department Of Labor $148 139%
Indiana Workers Comp $237 222%
One Call $275 257%
Encore Kba Epo $284 266%
Magnacare Ma $284 266%
Caresource $297 - $386 278%
Encore Kba Ppo $355 332%
Medicaid / KanCare $386 361%
Mhs $386 361%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 102 E Culver Rd, Knox, IN 46534
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals