CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 72125
Insurance Median: $308
Cash Discount Price: $603
vs. Medicare Baseline: 2.88x Medicare

The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Mary Hitchcock Memorial Hospital is $308. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $603. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.88x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$603

Average discount available for prompt cash payment at this facility.

Insurance Median

$308

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: $603 (565%)

Insurance Median: $308 (288%)

Cash: $603 (565% of Medicare)

Ins. Median: $308 (288% 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 288% of the Medicare baseline (a markup of 188%). 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
Amerihealth Caritas Nh	$13 - $337	12%
Beacon Health Strategies/Carelon	$13 - $363	12%
Granite State Health Plan	$13 - $375	12%
Wellsense Health Plan	$44 - $363	41%
Blue Cross Blue Shield	$46 - $2,793	43%
Martin'S Point Generations Advantage	$46 - $119	43%
Mvp	$46 - $1,993	43%
UnitedHealthcare	$46 - $2,285	43%
Aetna	$47 - $2,088	44%
Cigna	$47 - $2,041	44%
Martin'S Point Health Care	$47 - $1,026	44%
Wellcare Health Plans	$47 - $124	44%
Ambetter / Centene	$48 - $256	45%
Harvard Pilgrim Health Care Of Ne	$57 - $1,908	53%
Mass General Brigham Health Plan	$133 - $1,850	125%
Tufts Health Plan	$154 - $1,736	144%
Maine Community Health Options	$613 - $2,187	574%
Coventry	$838 - $2,588	785%
First Health/Hcvm	$838 - $2,588	785%
Phcs	$867 - $2,678	812%
Corvel	$886 - $2,737	830%
Ccmsi	$915 - $2,826	857%

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 $603.
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 Mary Hitchcock Memorial Hospital 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.