CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Pulaski Memorial Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $120
  • Cash Discount Price: $1,121
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Pulaski Memorial Hospital is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,121. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.12x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.
Cash / Self-Pay
$1,121

Average discount available for prompt cash payment at this facility.

Insurance Median
$120

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: $1,121 (1050%)
Insurance Median: $120 (112%)
Cash: $1,121 (1050% of Medicare)
Ins. Median: $120 (112% 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.

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
Mdwise Mcaid Hcc $44 - $99 41%
Mdwise Mcaid Hhw $44 - $99 41%
Mdwise Mcaid Hip - All Other Plans $44 - $950 41%
Ambetter / Centene $45 - $950 42%
Blue Cross Blue Shield $45 - $1,972 42%
Caresource Mcaid Hip $45 - $950 42%
Caresource Mcare Hmo $45 - $950 42%
Cenpatico Mcaid Hip $45 - $950 42%
Humana $45 - $2,464 42%
Mhs Mcaid Hip $45 - $950 42%
Mhs Mcare Allwell $45 - $960 42%
Multiplan - All Plans $45 - $2,758 42%
UnitedHealthcare $45 - $2,421 42%
Caresource Exch Hmo Hix - All Other Plans $56 - $1,187 52%
Encore Ppo - All Other Plans $68 - $2,605 64%
Community Health Alliance - All Plans $88 - $2,727 82%
Cigna $89 - $2,911 83%
Sagamore - All Other Plans $89 - $2,317 83%
Sagamore Rose Acre $89 - $2,283 83%
Caresource Mcaid Hhw $99 - $120 93%
Cenpatico Mcaid Hhw - All Other Plans $99 - $120 93%
Mhs Mcaid Hhw/Hcc $99 - $120 93%
Encore Workers Comp $124 - $2,758 116%
Aetna $1,103 1033%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 616 E 13Th St, Winamac, IN 46996
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals