CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Rockcastle County Hospital, Inc.

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $266
  • Cash Discount Price: $1,566
  • vs. Medicare Baseline: 2.49x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Rockcastle County Hospital, Inc. is $266. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,566. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.49x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$1,566

Average discount available for prompt cash payment at this facility.

Insurance Median
$266

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: $1,566 (1466%)
Insurance Median: $266 (249%)
Cash: $1,566 (1466% of Medicare)
Ins. Median: $266 (249% 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 249% of the Medicare baseline (a markup of 149%). 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
Tricare $74 69%
Blue Cross Blue Shield $98 - $847 92%
Caresource Mcr Adv-All Other Plans $98 92%
Humana $98 - $322 92%
Molina Marketplace - All Other Plans $98 92%
Molina Mcr Adv $98 92%
Signature Mcr Adv-All Plans $98 92%
Wellcare Mcr Adv-All Other Plans $98 92%
Passport Hp Hmo - All Plans $200 187%
Caresource Mcaid $209 196%
Coventry Mcaid-All Plans $209 196%
Medicaid / KanCare $209 196%
Molina Mcaid $209 196%
UnitedHealthcare $209 - $350 196%
Multiplan-All Plans $1,752 1640%
Prime Health Services-All Plans $1,752 1640%
Integrated Hp-All Plans $1,834 1717%
Corvel - All Plans $1,855 1737%
Center Care-All Plans $1,958 1833%
Cigna $1,999 1872%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals