CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Promedica Monroe Regional Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $255
  • Cash Discount Price: $1,481
  • vs. Medicare Baseline: 2.39x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Promedica Monroe Regional Hospital is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,481. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.39x the Medicare baseline. Located in 718 N Macomb St, Monroe, MI.
Cash / Self-Pay
$1,481

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: $1,481 (1387%)
Insurance Median: $255 (239%)
Cash: $1,481 (1387% 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.

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
Meridian $57 53%
Priority Health $57 - $1,253 53%
Blue Cross Blue Shield $60 - $1,280 56%
Aetna $62 - $1,604 58%
Molina Healthcare Of Michigan $62 58%
UnitedHealthcare $63 - $1,851 59%
Paramount Healthcare Inc $101 - $1,732 95%
Veterans Affairs $105 98%
Health Alliance Plan $106 - $1,869 99%
Humana $107 - $124 100%
Amerihealth $127 119%
Frontpath $1,322 1238%
Encore Health Network $1,595 1493%
Health Ohio Network, Llc $1,595 1493%
Cofinity $1,625 1521%
Multiplan $2,051 1920%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 718 N Macomb St, Monroe, MI 48162
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals