CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Mercy Hospital Carthage

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $1,121
Cash Discount Price: $1,327
vs. Medicare Baseline: 10.50x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Mercy Hospital Carthage is $1,121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,327. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.50x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.

Cash / Self-Pay

$1,327

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,121

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: $1,327 (1242%)

Insurance Median: $1,121 (1050%)

Cash: $1,327 (1242% of Medicare)

Ins. Median: $1,121 (1050% 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 1050% of the Medicare baseline (a markup of 950%). 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
Blue Cross Blue Shield	$60 - $561	56%
Medicaid / KanCare	$60 - $1,121	56%
Aetna	$72 - $1,816	67%
Humana	$72 - $612	67%
Medicare (plans)	$100 - $604	94%
UnitedHealthcare	$140 - $1,776	131%
Cherokee Nation Health Serv Contracted [320066]	$561	525%
Cigna	$561 - $1,837	525%
Cross Timbers Hospice [20098]	$561	525%
Dept Of Veteran Affairs Contracted [320106]	$561	525%
Elara Caring Aspire Hospice [20433]	$561	525%
Globalhealth Contracted [320145]	$561	525%
Halo Hcr Inc Hospice Contracted [320432]	$561	525%
Halo Hcr Inc Hospice [20432]	$561	525%
Indian Health Service Contracted [320198]	$561	525%
Kindful Hospice Contracted [320434]	$561	525%
Kindful Hospice [20434]	$561	525%
Medical Associates Health Contracted [320444]	$561	525%
Mercy Hospice Okc [20252]	$561	525%
Mercy Mgd Behavioral Health Contracted [320259]	$561	525%
Pace Of The Ozarks Contracted [320518]	$561	525%
Provider Partners Health Plans Contracted [320450]	$561	525%
Qual Choice Contracted [320325]	$561	525%
Tricare	$563	527%
Point C Contracted [320238]	$714 - $1,837	668%
Health Systems Inc Contracted [320174]	$878	822%
Insurance System Inc Contracted [320465]	$878	822%
Administrative Payor Contracted [320005]	$918	859%
Centivo Contracted [320505]	$939	879%
United Medical Resources Contracted [320454]	$1,031 - $1,837	965%
Healthscope Contracted [320182]	$1,063	995%
Ambetter / Centene	$1,121	1050%
Home State Health Plan Contracted [320187]	$1,121	1050%
Novasys Contracted [320285]	$1,121	1050%
Benefit Management Contracted [320052]	$1,225 - $1,776	1147%
Auxiant Contracted [320462]	$1,327 - $1,735	1242%
Healthlink Contracted [320179]	$1,327 - $1,898	1242%
Preferred Health Plan Contracted [320522]	$1,327	1242%
Workers Comp [20426]	$1,633 - $2,041	1529%
90 Degree Benefits Contracted [320436]	$1,735	1624%
Aither Health Contracted [320449]	$1,735	1624%
Ebms Contracted [320493]	$1,735	1624%
Edison Health Solutions Contracted [320502]	$1,735	1624%
Imagine 360 Contracted [320494]	$1,735	1624%
Mercy Benefit Admin Contracted [320251]	$1,735 - $1,837	1624%
Reflect Health Contracted [320492]	$1,735	1624%
Show-Me Health Administrators Contracted [320483]	$1,735	1624%
Yuzu Health Contracted [320521]	$1,735	1624%
Medica Contracted [320239]	$1,768	1655%
Evolutions Health Care Contracted [320124]	$1,776	1663%
First Health Contracted [320128]	$1,776	1663%
Multiplan Contracted [320270]	$1,776	1663%
Private Health Care Systems Contracted [320320]	$1,776	1663%
American Healthcare Alliance Contracted [320020]	$1,837	1720%
Ppo Plus Contracted [320310]	$1,837	1720%
Usa Managed Care Org Contracted [320429]	$1,837	1720%

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 $1,327.
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 Mercy Hospital Carthage 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.