CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Ochsner St Martin Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $459
Cash Discount Price: $539
vs. Medicare Baseline: 4.30x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Ochsner St Martin Hospital is $459. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $539. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.30x the Medicare baseline. Located in 210 Champagne Boulevard, Breaux Bridge, LA.

Cash / Self-Pay

$539

Average discount available for prompt cash payment at this facility.

Insurance Median

$459

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: $539 (505%)

Insurance Median: $459 (430%)

Cash: $539 (505% of Medicare)

Ins. Median: $459 (430% 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 430% of the Medicare baseline (a markup of 330%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UnitedHealthcare	$223 - $652	209%
Aetna	$396 - $1,636	371%
Blue Cross Blue Shield	$396 - $461	371%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$396	371%
Humana	$396 - $652	371%
Medicare (plans)	$396	371%
Ochsner Health Plan	$396	371%
Wellcare Of Louisiana	$396	371%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$407	381%
Tricare	$459	430%
Verity Commercial And First Choice Network	$629	589%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$652	610%
Healthy Blue (Healthy Louisiana)	$652	610%
Louisiana Healthcare Connections (Healthy Louisiana)	$652	610%
Zelis	$1,259	1179%
Cigna	$1,528	1431%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $539.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 72125.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ochsner St Martin Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 72125.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.