CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Shriners Hospitals for Children

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $157
Cash Discount Price: $3,241
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Shriners Hospitals for Children is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,241. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.47x the Medicare baseline. Located in 4400 Clayton Ave, Saint Louis, MO.

Cash / Self-Pay

$3,241

Average discount available for prompt cash payment at this facility.

Insurance Median

$157

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: $3,241 (3034%)

Insurance Median: $157 (147%)

Cash: $3,241 (3034% of Medicare)

Ins. Median: $157 (147% 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
Ambetter / Centene	$91	85%
Missouri Care	$91	85%
UnitedHealthcare	$102 - $112	95%
Aetna	$107 - $176	100%
Medicaid / KanCare	$107	100%
Soonercare	$110	103%
Cigna	$139	130%
Healthchoice Of Oklahoma	$213	199%
Blue Cross Blue Shield	$225	211%
Healthlink	$241	226%
Providence Health Plan	$264	247%

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 $3,241.
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 Shriners Hospitals for Children 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.