CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Hermann Area District Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $891
Cash Discount Price: $1,114
vs. Medicare Baseline: 8.34x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Hermann Area District Hospital is $891. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,114. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.34x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.

Cash / Self-Pay

$1,114

Average discount available for prompt cash payment at this facility.

Insurance Median

$891

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: $1,114 (1043%)

Insurance Median: $891 (834%)

Cash: $1,114 (1043% of Medicare)

Ins. Median: $891 (834% 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 834% of the Medicare baseline (a markup of 734%). 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
Healthy Blue Mcaid - All Plans	$139	130%
Ambetter / Centene	$145 - $1,398	136%
Blue Cross Blue Shield	$150 - $1,617	140%
UnitedHealthcare	$150 - $834	140%
Healthlink Hmo	$515	482%
Care Partners Mcaid- All Plans	$562	526%
Healthlink Ppo - All Other Plans	$618	579%
Tricare	$684 - $786	640%
Choicecare Mcr Adv- All Plans	$725 - $834	679%
American Hlth Mcr Adv- All Plans	$760 - $874	712%
Humana	$760 - $874	712%
Aetna	$775 - $1,887	726%
Wellcare Mcr Adv - All Plans	$775 - $891	726%
Cigna	$941 - $1,082	881%
Harmony Hp Mcaid- All Plans	$1,001 - $1,152	937%
Healthcare Usa Mcaid- All Plans	$1,122 - $1,291	1050%
Multiplan/Phcs - All Plans	$1,295 - $1,490	1212%
Coventry - All Plans	$1,468 - $1,688	1374%
Comp Results - All Plans	$1,554 - $1,787	1455%
Three Rivers - All Plans	$1,554 - $1,787	1455%

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 $1,114.
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 Hermann Area District 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.