CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Atrium Health Lincoln

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $835
Cash Discount Price: $1,514
vs. Medicare Baseline: 7.82x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Atrium Health Lincoln is $835. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,514. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.82x the Medicare baseline. Located in 433 McAlister Rd, Lincolnton, NC.

Cash / Self-Pay

$1,514

Average discount available for prompt cash payment at this facility.

Insurance Median

$835

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: $1,514 (1417%)

Insurance Median: $835 (782%)

Cash: $1,514 (1417% of Medicare)

Ins. Median: $835 (782% 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 782% of the Medicare baseline (a markup of 682%). 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
Cigna	$44 - $2,044	41%
Humana	$45 - $123	42%
Aetna	$46 - $2,574	43%
UnitedHealthcare	$46 - $1,726	43%
Trillium	$48 - $358	45%
Alliance	$49 - $355	46%
Amerihealth Caritas	$49 - $342	46%
Carolina Complete Health	$49 - $348	46%
Healthy Blue	$49 - $348	46%
Partners	$49 - $351	46%
Vaya	$49 - $351	46%
Wellcare	$49 - $348	46%
Orthocarolina	$55 - $151	51%
Blue Cross Blue Shield	$868 - $1,540	813%
Ambetter / Centene	$990 - $1,126	927%
Employers Health Network	$1,338	1253%
Medcost	$1,426 - $1,980	1335%
Physician Reach Out	$1,514	1417%
Gmmi	$1,968	1843%
Quik Trip	$1,968	1843%
Choicecare	$2,483	2325%
First Health	$2,574	2410%
Beechstreet	$2,725	2551%
Private Health Care Systems	$2,725	2551%
Multiplan	$2,877	2694%

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 $1,514.
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 Atrium Health Lincoln 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.