CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $115
Cash Discount Price: $1,431
vs. Medicare Baseline: 1.08x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Munson Healthcare Otsego Memorial Hospital is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,431. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.08x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$1,431

Average discount available for prompt cash payment at this facility.

Insurance Median

$115

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: $1,431 (1340%)

Insurance Median: $115 (108%)

Cash: $1,431 (1340% of Medicare)

Ins. Median: $115 (108% 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.

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	$30 - $1,052	28%
Mclaren Health Plan	$30 - $1,412	28%
Meridian	$30 - $54	28%
Molina	$30 - $132	28%
Priority Health	$30 - $294	28%
UnitedHealthcare	$30 - $1,349	28%
Aetna	$46 - $1,364	43%
Blue Care Network	$46 - $123	43%
Hap (Health Alliance Plan)	$46 - $1,347	43%
Humana	$46 - $123	43%
Medicare (plans)	$46 - $123	43%
Michigan Amish Medical Board	$46 - $123	43%
Northern Michigan Mennonite Group	$46 - $123	43%
Asr Physicians Care Network	$69 - $1,347	65%
Cigna	$70 - $294	66%
Nomi Health	$73 - $1,347	68%
Employee Benefit Logistics	$78 - $208	73%
Munson Hospice	$852 - $1,179	798%
Hospice Of Michigan	$1,010	946%
Enterprise Group Planning/Employee Benefit Plan	$1,347	1261%
Cofinity	$1,431	1340%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$1,431	1340%
Three Rivers Provider Network	$1,431	1340%

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 $1,431.
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 Munson Healthcare Otsego Memorial 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.