CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: North Adams Regional Hospital Corporation

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $938
  • Cash Discount Price: $1,979
  • vs. Medicare Baseline: 8.78x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at North Adams Regional Hospital Corporation is $938. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,979. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.78x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$1,979

Average discount available for prompt cash payment at this facility.

Insurance Median
$938

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: $1,979 (1853%)
Insurance Median: $938 (878%)
Cash: $1,979 (1853% of Medicare)
Ins. Median: $938 (878% 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 878% of the Medicare baseline (a markup of 778%). 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
Mcd New York $90 - $105 84%
Mcd Masshealth $105 - $181 98%
Mcd Out Of State $105 - $181 98%
Mcdmanaged Cdphp $105 - $181 98%
Mcdmanaged Hne Mcdaco $105 - $181 98%
Medicaid / KanCare $105 - $917 98%
Comm Network Qhpsub $116 - $1,177 109%
Mcdmanaged Network $116 - $1,177 109%
Mcdmanaged Bmchnp $121 - $189 113%
Medicare (plans) $134 - $484 125%
Tricare $134 - $784 125%
Comm Hospice $136 - $479 127%
Mcr Miscellaneous $136 - $479 127%
Mcrmanaged Usa Family $136 - $479 127%
Mcrmanaged Va $136 - $479 127%
Oth United Vaccn $136 - $479 127%
Blue Cross Blue Shield $154 - $1,771 144%
Mcrmanaged Cca One Care $154 - $474 144%
Aetna $160 - $1,573 150%
Comm Fallon Qhp $201 - $1,179 188%
Comm Hne Hmo $255 - $1,373 239%
Comm Hne $271 - $1,453 254%
Comm Hne Ppo $271 - $1,459 254%
Wc Workers Comp $285 - $1,264 267%
Comm Unicare $402 - $1,351 376%
Comm Network Qhpnonsub $928 - $1,498 869%
Comm Nhp $938 - $1,348 878%
Comm Tufts $1,149 - $1,650 1076%
UnitedHealthcare $1,247 - $1,792 1167%
Cigna $1,305 - $1,938 1222%
Comm Cdphp $1,305 - $1,875 1222%
Comm Mvp $1,305 - $1,875 1222%
Comm Oxford $1,305 - $1,875 1222%
Comm First Health $1,349 - $1,979 1263%
Comm Connecticare $1,378 - $1,979 1290%
Comm Consolidated Health $1,378 - $1,979 1290%
Comm Harvard $1,378 - $1,979 1290%
Comm Other $1,378 - $1,979 1290%
Comm Phcs $1,378 - $1,979 1290%
Comm Self Pay $1,378 - $1,979 1290%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals