CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Essentia Health Sandstone

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $1,330
  • Cash Discount Price: $1,435
  • vs. Medicare Baseline: 12.45x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Essentia Health Sandstone is $1,330. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,435. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.45x the Medicare baseline. Located in 705 Lundorff Drive South, Sandstone, MN.
Cash / Self-Pay
$1,435

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,330

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: $1,435 (1344%)
Insurance Median: $1,330 (1245%)
Cash: $1,435 (1344% of Medicare)
Ins. Median: $1,330 (1245% 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 1245% of the Medicare baseline (a markup of 1145%). 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
Itasca Med Care $106 99%
Primewest $106 99%
Blue Cross Blue Shield $746 - $1,560 698%
Blue Plus Pmap Pcc Prime $746 - $1,068 698%
Medica Access $773 - $1,210 724%
Healthpartners Care Pmap $781 731%
Sanford Healthplan $833 - $877 780%
Advocare/Security Health $913 855%
Freedom Blue Ppo $913 855%
Healthpartners Care Msho / Mcr Adv $913 855%
Imcare Msho Pcc Prime $913 855%
Imcare Msho Ref Req $913 855%
Medica Advantage Solutions $913 855%
Medica Msho/Dual Solutions $913 855%
Medica Prime Solution Group $913 855%
Medicare (plans) $913 855%
Nd Va Administration $913 855%
Platinum Blue/Vantage Blue $913 855%
Primewest Msho $913 855%
Secure Blue Msho $913 855%
Ubh Cost Plan $913 855%
Ubh Msho $913 855%
Ucare Msho $913 855%
UnitedHealthcare $913 - $1,768 855%
Ucare $1,278 1197%
Healthpartners $1,313 - $1,548 1229%
Medica $1,389 - $1,544 1300%
Medica Uplan $1,389 1300%
Wea $1,398 - $1,495 1309%
America'S Ppo $1,505 1409%
Cigna $1,515 - $1,548 1418%
Healthpartners Pcc Prime $1,515 - $1,548 1418%
Medica Choice $1,590 1489%
Wps $1,612 - $1,631 1509%
Aetna $1,651 1546%
Security Health $1,942 1818%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 705 Lundorff Drive South, Sandstone, MN 55072
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals