CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Novant Health Presbyterian Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $1,137
Cash Discount Price: $1,040
vs. Medicare Baseline: 10.65x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Novant Health Presbyterian Medical Center is $1,137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,040. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.65x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.

Cash / Self-Pay

$1,040

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,137

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: $1,040 (974%)

Insurance Median: $1,137 (1065%)

Cash: $1,040 (974% of Medicare)

Ins. Median: $1,137 (1065% 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 1065% of the Medicare baseline (a markup of 965%). 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	$102 - $1,534	95%
Humana	$102 - $1,872	95%
Pace Of The Southern Piedmont	$102	95%
UnitedHealthcare	$102 - $1,518	95%
Aetna	$104 - $2,080	97%
Cigna	$105 - $1,339	98%
Liberty Health	$107	100%
Nc Department Of Public Safety	$203 - $453	190%
Carolina Complete	$358 - $453	335%
Amerihealth	$365 - $462	342%
Wellcare	$365 - $462	342%
Caresource North Carolina	$678 - $858	635%
Atlantic Corporation Dba Atlantic Packaging	$946 - $1,196	886%
Amps	$1,131 - $1,430	1059%
Plotkin Health	$1,234 - $1,560	1155%
Medcost	$1,460 - $1,950	1367%
Primary Physician Care	$1,521 - $1,924	1424%
Multiplan	$1,542 - $1,950	1444%
Phcs	$1,542 - $1,950	1444%
Employers Choice Network	$1,994 - $2,522	1867%
Three Rivers Provider Network	$1,994 - $2,522	1867%

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 $1,040.
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 Novant Health Presbyterian Medical Center 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.