CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Highlands Cashiers Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $1,908
  • Cash Discount Price: $4,268
  • vs. Medicare Baseline: 17.86x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Highlands Cashiers Hospital is $1,908. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,268. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 17.86x the Medicare baseline. Located in 190 Hospital Drive, Highlands, NC.
Cash / Self-Pay
$4,268

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,908

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: $4,268 (3996%)
Insurance Median: $1,908 (1786%)
Cash: $4,268 (3996% of Medicare)
Ins. Median: $1,908 (1786% 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 1786% of the Medicare baseline (a markup of 1686%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Apex Health $854 800%
Cigna $1,400 - $1,895 1311%
Blue Cross Blue Shield $1,452 - $1,536 1359%
United $1,474 - $2,586 1380%
Wellcare $1,496 1401%
Amerihealth $1,510 1414%
Partners Health Management $1,525 1428%
Vaya Health $1,525 1428%
Amerihealth Caritas $1,622 1519%
Caresource $1,878 1758%
Medcost $2,002 - $2,408 1874%
Aetna $2,049 - $3,103 1918%
Magellan $2,561 2398%
Magellan Behavioral Health $2,561 2398%
Multiplan $3,414 3196%
Avalon Administrative Services $3,628 3397%
Prime Health $3,756 - $3,841 3517%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 190 Hospital Drive, Highlands, NC 28741
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals