CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Mainehealth Pen Bay Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $255
Cash Discount Price: $1,061
vs. Medicare Baseline: 2.39x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Mainehealth Pen Bay Hospital is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,061. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.39x the Medicare baseline. Located in 6 Glen Cove Drive, Rockport, ME.

Cash / Self-Pay

$1,061

Average discount available for prompt cash payment at this facility.

Insurance Median

$255

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: $1,061 (993%)

Insurance Median: $255 (239%)

Cash: $1,061 (993% of Medicare)

Ins. Median: $255 (239% 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 239% of the Medicare baseline (a markup of 139%). 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
Blue Cross Blue Shield	$45 - $500	42%
Aetna	$46 - $1,684	43%
Wellcare	$46 - $133	43%
Humana	$52 - $148	49%
UnitedHealthcare	$52 - $1,788	49%
Multiplan	$88 - $1,805	82%
Harvard Pilgrim Healthcare	$90 - $1,635	84%
Community Health Options	$95 - $1,522	89%
Cigna	$837 - $1,515	784%

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 $1,061.
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 Mainehealth Pen Bay 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.