CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $494
Cash Discount Price: $2,030
vs. Medicare Baseline: 4.63x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at UMass Memorial Health - Harrington Hospital is $494. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,030. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.63x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$2,030

Average discount available for prompt cash payment at this facility.

Insurance Median

$494

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: $2,030 (1901%)

Insurance Median: $494 (463%)

Cash: $2,030 (1901% of Medicare)

Ins. Median: $494 (463% 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 463% of the Medicare baseline (a markup of 363%). 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
Champva [11001]	$126	118%
Cigna	$127 - $1,567	119%
Institution [10406]	$127	119%
Mgb Mcr [10124]	$127	119%
Tufts Us Family [11203]	$127	119%
Blue Cross Blue Shield	$131 - $494	123%
Aetna	$133 - $2,030	125%
Commonwealth Care Alliance [10103]	$133	125%
Fallon Mcr Supp [20202]	$133	125%
Fallon Mcr [10105]	$133	125%
Tufts Mcr [10112]	$133	125%
UnitedHealthcare	$133 - $2,030	125%
Senior Whole Health [10110]	$136	127%
Tufts Connectorcare [10507]	$216	202%
Workers Compensation [20501]	$285	267%
Wellpoint [11112]	$413	387%
Hsno/Free Care [10801]	$681	638%
Medicaid / KanCare	$1,056	989%
Hne [11108]	$1,321	1237%
First Health Network [11120]	$1,522	1425%
Evernorth Behavioral Health [27]	$1,624	1520%
Connecticare [11105]	$2,030	1901%
Fallon Carelon Hlth [28]	$2,030	1901%
Fallon Mcaid Carelon Hlth [29]	$2,030	1901%
Grants [20507]	$2,030	1901%
Masshealth Mcd Mbhp [38]	$2,030	1901%
Wellsense Mcaid Carelon Hlth [21]	$2,030	1901%

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 $2,030.
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 UMass Memorial Health - Harrington 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.