CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Blue Ridge Regional Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $1,733
  • Cash Discount Price: $4,268
  • vs. Medicare Baseline: 16.23x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Blue Ridge Regional Hospital is $1,733. 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 16.23x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$4,268

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,733

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: $1,733 (1623%)
Cash: $4,268 (3996% of Medicare)
Ins. Median: $1,733 (1623% 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 1623% of the Medicare baseline (a markup of 1523%). 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
Blue Cross Blue Shield $683 - $716 639%
United $727 - $2,019 681%
Wellcare $738 691%
Amerihealth $745 698%
Partners Health Management $752 704%
Vaya Health $752 704%
Aetna $854 - $3,086 800%
Apex Health $854 800%
Cigna $1,451 - $1,746 1358%
Amerihealth Caritas $1,579 1478%
Caresource $1,878 1758%
Medcost $1,989 - $2,210 1862%
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: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals