CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Essentia Health

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $987
  • Cash Discount Price: $1,645
  • vs. Medicare Baseline: 9.24x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Essentia Health is $987. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,645. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.24x the Medicare baseline. Located in 3000 32Nd Ave South, Fargo, ND.
Cash / Self-Pay
$1,645

Average discount available for prompt cash payment at this facility.

Insurance Median
$987

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: $1,645 (1540%)
Insurance Median: $987 (924%)
Cash: $1,645 (1540% of Medicare)
Ins. Median: $987 (924% 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 924% of the Medicare baseline (a markup of 824%). 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
Advocare/Security Health $106 99%
Blue Cross Blue Shield $106 - $1,480 99%
Freedom Blue Ppo $106 99%
Healthpartners Care Msho / Mcr Adv $106 99%
Imcare Msho Pcc Prime $106 99%
Imcare Msho Ref Req $106 99%
Itasca Med Care $106 99%
Medica Advantage Solutions $106 99%
Medica Msho/Dual Solutions $106 99%
Medica Prime Solution Group $106 99%
Medicare (plans) $106 99%
Nd Va Administration $106 99%
Platinum Blue/Vantage Blue $106 99%
Primewest $106 99%
Primewest Msho $106 99%
Secure Blue Msho $106 99%
Ubh Cost Plan $106 99%
Ubh Msho $106 99%
Ucare Msho $106 99%
UnitedHealthcare $106 - $1,748 99%
Sanford Health Plan $188 - $990 176%
Medica Access $588 551%
Healthpartners Care Pmap $853 799%
Medica $1,215 - $1,351 1138%
Medica Uplan $1,215 1138%
Medica Choice $1,390 1301%
Ucare $1,443 1351%
Cigna $1,469 1375%
Healthpartners $1,469 1375%
Healthpartners Pcc Prime $1,469 1375%
Wea $1,579 - $1,689 1478%
America'S Ppo $1,700 1592%
Wps $1,820 - $1,842 1704%
Aetna $1,864 1745%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3000 32Nd Ave South, Fargo, ND 58104
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals