CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Essentia Health Ada

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $1,278
  • Cash Discount Price: $1,435
  • vs. Medicare Baseline: 11.97x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Essentia Health Ada is $1,278. 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 11.97x the Medicare baseline. Located in 201 9Th Street West, Ada, MN.
Cash / Self-Pay
$1,435

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,278

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: $1,278 (1197%)
Cash: $1,435 (1344% of Medicare)
Ins. Median: $1,278 (1197% 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 1197% of the Medicare baseline (a markup of 1097%). 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%
Healthpartners Care Pmap $755 707%
Medica Access $773 - $1,210 724%
Sanford Health Plan $833 - $877 780%
Advocare/Security Health $932 873%
Blue Cross Blue Shield $932 - $1,693 873%
Freedom Blue Ppo $932 873%
Healthpartners Care Msho / Mcr Adv $932 873%
Imcare Msho Pcc Prime $932 873%
Imcare Msho Ref Req $932 873%
Medica Advantage Solutions $932 873%
Medica Msho/Dual Solutions $932 873%
Medica Prime Solution Group $932 873%
Medicare (plans) $932 873%
Nd Va Administration $932 873%
Platinum Blue/Vantage Blue $932 873%
Primewest Msho $932 873%
Secure Blue Msho $932 873%
Ubh Cost Plan $932 873%
Ubh Msho $932 873%
Ucare Msho $932 873%
UnitedHealthcare $932 - $1,758 873%
Blue Plus Pmap Pcc Prime $1,068 - $1,692 1000%
Healthpartners $1,181 - $1,291 1106%
Ucare $1,278 1197%
Cigna $1,291 1209%
Healthpartners Pcc Prime $1,291 1209%
Wea $1,398 - $1,495 1309%
America'S Ppo $1,505 1409%
Wps $1,612 - $1,631 1509%
Medica $1,614 - $1,699 1511%
Medica Uplan $1,614 1511%
Aetna $1,651 1546%
Medica Choice $1,750 1638%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 9Th Street West, Ada, MN 56510
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals