CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Woodlawn Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $549
  • Cash Discount Price: $1,873
  • vs. Medicare Baseline: 5.14x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Woodlawn Hospital is $549. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,873. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.14x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.
Cash / Self-Pay
$1,873

Average discount available for prompt cash payment at this facility.

Insurance Median
$549

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: $1,873 (1754%)
Insurance Median: $549 (514%)
Cash: $1,873 (1754% of Medicare)
Ins. Median: $549 (514% 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 514% of the Medicare baseline (a markup of 414%). 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
Blue Cross Blue Shield $99 - $1,898 93%
Caresource Mcaid Hww $99 93%
Mdwise Excel Hhw & Hcc $99 93%
Mhs Mcaid Hcc $99 93%
Mhs Mcaid Hhw $99 93%
UnitedHealthcare $99 - $1,898 93%
Aetna $549 - $2,372 514%
Caresource Mcaid Hip $549 514%
Caresource Mcr Adv $549 514%
Humana $549 - $1,938 514%
Mdwise Mcaid Excel Hip $549 514%
Mhs Exch Mrktplce-All Other Plans $549 514%
Mhs Mcaid Hip $549 514%
Mhs Mcr Adv $560 524%
Caresource Exch - All Other Plans $714 668%
Ambetter / Centene $731 684%
Partners Direct Health-All Plans $1,698 1590%
Cigna $1,788 - $2,122 1674%
Parkview Health Plans-All Plans $1,873 1754%
Sagamore All Other Grps - All Other Plans $2,097 1963%
Encore Comm-All Plans $2,122 1987%
Phcs/Multiplan-All Plans $2,322 2174%
Community Health Alliance-All Plans $2,372 2221%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1400 E 9Th St, Rochester, IN 46975
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals