CMS Price Transparency Data

CT scan, neck (cervical spine)

Facility: Raritan Bay Medical Center

Billing Code: 72125 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 72125
  • Insurance Median: $543
  • Cash Discount Price: $118
  • vs. Medicare Baseline: 5.08x Medicare
The contracted insurance negotiated median rate for a CT scan, neck (cervical spine) at Raritan Bay Medical Center is $543. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.08x the Medicare baseline. Located in 530 New Brunswick Ave, Perth Amboy, NJ.
Cash / Self-Pay
$118

Average discount available for prompt cash payment at this facility.

Insurance Median
$543

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: $118 (110%)
Insurance Median: $543 (508%)
Cash: $118 (110% of Medicare)
Ins. Median: $543 (508% 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 508% of the Medicare baseline (a markup of 408%). 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
Karna $86 - $256 81%
Blue Cross Blue Shield $118 110%
Vaccn $118 110%
Wellcare $118 110%
United Community/Americhoice $124 116%
Amerigroup $126 118%
Aetna $128 - $2,326 120%
UnitedHealthcare $141 - $714 132%
Cigna $258 - $2,376 242%
Oxford $265 248%
Horizon $281 - $2,869 263%
Clover $535 501%
Amerihealth $551 - $555 516%
Seoul Medical Group $615 576%
Activecare First McO $954 893%
Qualcare $1,752 - $2,921 1640%
Brighton Health Plan $2,049 1918%
Bergen Risk $2,228 2086%
Multiplan - PHCS $2,524 2363%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 New Brunswick Ave, Perth Amboy, NJ 08861
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals